We applied Demons and accelerated Demons elastic registration algorithm in radiotherapy cone beam CT (CBCT) images, We provided software support for real-time understanding of organ changes during radiotherapy. We wrote a 3D CBCT image elastic registration program using Matlab software, and we tested and verified the images of two patients with cervical cancer 3D CBCT images for elastic registration, based on the classic Demons algorithm, minimum mean square error (MSE) decreased 59.7%, correlation coefficient (CC) increased 11.0%. While for the accelerated Demons algorithm, MSE decreased 40.1%, CC increased 7.2%. The experimental verification with two methods of Demons algorithm obtained the desired results, but the small difference appeared to be lack of precision, and the total registration time was a little long. All these problems need to be further improved for accuracy and reducing of time.
Algorithms ; Cone-Beam Computed Tomography ; Humans ; Image Interpretation, Computer-Assisted ; Imaging, Three-Dimensional ; Software

s:Objective To study the effective ingredients of Shuangshenningxin Fang (SSNX). Methods Based on analyzing the HPLC fingerprints of rat samples obtained after orally taking SSNX, the ingredients absorbed into blood were identified. The cultured cells were subject to hypoxia and reoxygenation. The leakage of lactic dehydrogenase (LDH) from cardiomyocytes was measured. Results Fifteen ingredients were detected after oral administration of SSNX. Dl-tetarhydropalmatine (Dl-THP), salvianolic acid B (Sal B), ginsenosides (Rg1) and dehydeocorydaline (DHC) were identified. Rg1 and DHC reduced the LDH leakage (P

Objective:To investigate the clinical efficacy of amoxicillin combined with metronidazole in the treatment of peri-implantitis and its effect on serum matrix metalloproteinase-8 (MMP-8), tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) levels.Methods:Sixty-four patients with peri-implantitis who received treatment from January 2017 to December 2019 in Xiasha Hospital, SiR Run Run Shaw Hospital, Zhejiang University School of Medicine were included in this study. They were randomly assigned to receive treatment with metronidazole (control group, n = 32) or amoxicillin combined with metronidazole (observation group, n = 32). Clinical efficacy, periodontal pocket depth (PD), clinical attachment level (CAL), sulcus bleeding index (SBI), plaque index (PLI), matrix metalloproteinase-8 (MMP-8), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) levels and the incidence of adverse reactions were compared between the control and observation groups. PD, CAL, SBI and PLI were correlated with MMP-8, TNF-α and IL-1β levels. Results:The clinical efficacy in the observation group was significantly higher than that in the control group [93.75% (30/32) vs. 75.00% (24/32), χ2 = 4.267, P < 0.05]. After treatment, PD [(3.02 ± 0.24) mm], CAL [(1.70 ± 0.14) mm], SBI [(11.54 ± 3.26)%], PLI (0.87 ± 0.11) in the observation group were significantly lower than those in the control group [(4.47 ± 1.37) mm, (3.77 ± 1.06) mm, (18.84 ± 5.11)%, (1.12 ± 0.15), t = 5.897, 10.952, 6.813, 7.603, all P < 0.01]. After treatment, serum MMP-8 [(0.78 ± 0.23) μg/L], TNF-α [(71.24 ± 10.33) μg/L], IL-1β [(1.20 ± 0.14) μg/L] levels in the observation group were significantly lower compared with the control group [(1.12 ± 0.35) μg/L, (113.28 ± 15.73) μg/L, (2.55 ± 1.02) μg/L, t = 4.592, 12.637, 7.417, all P < 0.01]. Spearman correlation coefficient analysis showed that PD, CAL, SBI and PLI were positively correlated with serum MMP-8, TNF-α and IL-1β levels (all P < 0.01). Conclusion:Amoxicillin combined with metronidazole is highly effective in the treatment of peri-implantitis because it can promote plaque regression, reduce inflammatory reaction, and has a certain clinical promotion value.

OBJECTIVE: To study the status quo and future trend of digestive system drugs used in our hospital. METHO-DS: The digestive system drugs used in our hospital between 2001 and 2005 were analyzed retrospectively in respect to drug kinds, consumption sum, DDDs, daily costs etc. RESULTS: Drugs for peptic ulcer and hepatobiliary diseases took a big proportion and experienced a year- on- year increase. No significant change was noted for the top 10 drugs on the lists of DDDs and consumption sum before and after the medical insurance reform, but their order changed a little. The DDDs of most of the cheap and effective drugs increased after the medical insurance reform. CONCLUSION: The consumption of antiulcer drugs and drugs for hepatobiliary diseases in our hospital assume an increasing tendency.

Objective To evaluate the effect of type Ⅱ odontoid fracture,type Ⅰ Hangman fracture,C2-C3 disc injury on stability of C1-C2 and C2-C3 segments and investigate the clinical significance.Methods Ten fresh-frozen cadaveric cervical specimens (5 men and 5 women; 25-45 years of age,mean 35.7 years) were selected to test the stability of C1-C2 and C2-C3 segments in the settings of intact condition (control group),type Ⅰ Hangman fracture,type Ⅱ odontoid fracture,type Ⅰ Hangman fracture + type Ⅱ odontoid fracture,type Ⅰ Hangman fracture + type Ⅱ odontoid fracture + C2-C3 disc injury.Range of motion (ROM) and neutral zone (NZ) of those segments were measured.Results Compared with the intact condition,type Ⅰ Hangman fracture produced no significant variations in C1-C2 ROM in all loading modes and C2-C3 ROM during left and right lateral bending; type Ⅱ odontoid fracture produced no significant variations in C2-C3 ROM in all loading modes and C1-C2 ROM during left and right rotation; type Ⅰ Hangman fracture + type Ⅱ odontoid fracture revealed no significant variations in C1-C2 ROM during left and right rotation and C2-C3 ROM during extention; type Ⅰ Hangman fracture + type Ⅱ odontoid fracture + C2-C3 disc injury produced no significant variations in C1-C2 ROM during left and right lateral bending and extension-flextion and C2-C3 ROM in all loading modes (P ＜ 0.05).Conclusions Type Ⅰ Hangman fracture can reserve C1-C2 segmental left and right rotation and extension-flextion; type Ⅱ odontoid fracture can reserve C1-C2 segmental left and right lateral bending and extension-flextion; type Ⅰ Hangman fracture + type Ⅱ odontoid fracture + C2-C3 disc injury can reverse atlantoaxial rotationary stability and C1-C3 segmental stability in all directions.This study provides the biomechanical basis for clinical treatments and the related researches of internal fixation.

Objective To explore a new method of comparing the references images first to enhance the precision of the central point of the radiation treatment planning(RTP), try to establish a reference standard for this method in the nasopharyngeal cancer(NPC)and carcinoma of utercin cervix in the work of position verification. Methods For 50 RTPs of NPC and 20 RTPs of carcinoma of utercin cervix, the reference-CT-images in set-up and in position verification were compared, and to measure the difference between the two images. Then, in the same way, compare and measure the difference in the central-pointimages. Results For NPC, there was over 90% RTPs in which every difference measured was less than 2 mm;for carcinoma of utercin cervix, over 80% RTPs meet the criterion:the value of △MU1 ' or △MU2' was less than 5 mm and the others are less than 3 mm. Conclusions By comparing the references-CT-images in set-up and in position verification, the precision of the central point of the RTP is enhanced. The marks on the skin become more credible. So, it is feasible to perform the criterions in the work of position verification:for NPC every difference measured is less than 2 mm;for carcinoma of utercin cervix the value of △MU1 ' or △MU2 ' is less than 5 mm and the others are less than 3 mm.

Objective To investigate the effect of X-ray irradiation on neurites growth of primary hippocampal neurons in vitro.Methods Primary hippocampal neuron culture in vitro were irradiated with 0,2,4,8,10,12 Gy of X-rays.In the first day and the third day after irradiation,the cell death of primary hippocampal neurons was detected by MTT method,and the morphological changes of primary hippocampal neuronal neurites were detected with immunofluorescence staining method.Results In the first day and third day after irradiation,the cell death of hippocampal neurons increased significantly (F =123.068,43.370,P ＜0.05),but there were no significant difference among 4,8,10,and 12 Gy irradiation groups.Immunofluorescence staining showed that,in the first day after irradiation,the neurite length and total dendritic branch length (TDBL) were significantly changed (F =9.169,7.856,P ＜0.05),and in the third day after radiation,the neurite length,TDBL and total dendritic branch tip number (TDBTN) were also altered (F =23.797,6.565,6.021,P ＜ 0.05).Conclusion X-ray irradiation can inhibit the growth of neurites in the primary hippocampal neurons in vitro.

1H-nuclear magnetic resonance spectroscopy ( 1H-NMRs ) analysis was performed on serum specimens obtained from 60 preoperative patients with esophageal squamous cell carcinoma ( ESCC )and 30 healthy controls, and supernatant from 2 ESCC cell lines Eca-109 and TE-13.The characteristic fingerprint was profiled with 1H-NMRs data in healthy controls.Serum 1H-NMRs from 60 preoperative patients with ESCC were measured and compared with the 1H-NMRs from 30 healthy controls.We found some specific peaks in 1H-NMRs profile of serum specimens from ESCC patients, especially at 1.0-1.2 mg/L and 3.4 - 3.6 mg/L.The results were verified by the 1H-NMRs measurement on the supernatant from 2 ESCC cell lines Eca-109 and TE-3.Our results suggest that this two absorption peaks may be characteristic for ESCC and 1H-NMRs analysis on serum specimens may provide information for early diagnosis of ESCC.

Objective To investigate the clinical outcomes of pedicle screw fixation assisted with the 3D printing positioning guide template for treatment of unstable atlas fractures.Methods A retrospective case series review was made on 10 patients with unstable atlas fractures undergone direct posterior C1 pedicle screw fixation assisted with the 3D printing drill guide template from September 2012 to May 2015.There were 7 males and 3 females,with a mean age of 52.6 years (range,23-75 years).All patients complained of neck pain,stiffness and decreased range of motion without neurologic deficit.Preoperative skull traction was used routinely.After the three-dimension reconstruction of cervical vertebrae,ideal trajectory for C1 pedicle screws was designed with a complementary basal template for posterior surface of atlas corresponding anatomical structure.Then the drill guide template was materialized in a rapid prototyping machine and used during operation.Start point and direction of the ideal and actual trajectories were measured after matching the position of the pre-and post-operative patients' cervical spine.Safety of pedicle screw fixation was assessed in the transverse and sagittal planes of CT scan.Operation time and blood loss were recorded.Visual Analogue Scale (VAS) of neck pain was recorded before operation and 3 months after operation.Clinical efficacy,fracture reduction,stability and surgical complications were reviewed at the follow-up.Results A total of 20 screws were inserted safely.No significant differences existed in deviation of entry point and direction between ideal and actual trajectories (P ＞0.05).Operation time was 60-90 min (mean,75 min) and intraoperative blood loss was 110-300 ml (mean,160 ml).No spinal cord or vertebral artery injury was noted during operation.All patients were followed up for 12-36 months (mean,20.5 months).VAS was improved from preoperative 7.3 (6.3-9.5) points to 1.4 (0.3-2.5) points 3 months after operation (P ＜ 0.05).All patients had normal range of motion of the cervical spine 3 months after operation.Bony fusion was achieved 6 months after operation.At the follow-up,good cervical alignment was maintained with no instrument failure and C1.2 instability.Conclusion For treatment of unstable atlas fractures,direct posterior C1 pedicle screw fixation assisted with the 3D printing drill guide template can improve the precision of screw placement,reduce complications,and preserve the function of the occipital-atlantoaxial junction.

Objective To explore the prophylactic effect of methylprednisolone combined with granisetron on postoperative nausea and vomiting.Methods Two hundred patients scheduled for lumpectomy of breast were randomly divided into four groups with 50 cases each.The patients in group M1 received a pre-anesthesia intravenous doses of methylprednisolone 25 mg,the patients in group M2 were injected methylpredsisolone 25 mg repeatedly four hours later,in group D received a pre-anesthesia doses of dexamethasone 5 mg,in group N normal saline 2 ml.All the four groups of patients received granisetron 3 mg intravenously at the end of surgery.The incidence of nausea and vomiting in the 24 hours were observed.Results The PONV incidences of group M1,M2,D,N were 36%,18%,38% and 58%.Both group M1,M2 and D significantly decreased the total inci-dence of PONV (P <0.05)in the 24 h.The incidence of PONV was significantly lower in group M2, compared with group M1 and group D respectively (P <0.05).Conclusion Methylprednisolone-gran-isetron combination is as equally effective as dexamethasone-granisetron combination for preventing PONV in lumpectomy,but repeated methylprednisolone after 4 h is more effective than dexametha-sone and single-used methylprednisolone.