Objective To study the feasibility of dose calculation using kilovoltage X-ray cone-beam CT (KVCBCT) imaging for head-and-neck radiation therapy.Methods 11 patients with nasopharyngeal carcinoma were scanned with KVCBCT to adjust position before treatment, and rescanning images with KVCBCT after correction were input a treatment-planning system.The dose was recalculated by applying the patients′ treatment plans based on planning CT to the KVCBCT images.The dose distributions and dose volume histograms (DVH) of the tumor and critical structures were compared with the original treatment plan.Results The DVH and dose distribution of the plan based on the KVCBCT are compared with that of the planning CT, and they shows a good consistency for the 11 cases.The doses calculated from the planning CT and KVCBCT were compared on the isocenter planes.Using γ analysis with a criterion of 3%/3 mm, 98.0%±1.33% of the points on the isocenter planes in the planning CT and KVCBCT.The difference of the dose to target volume was<1% and to normal structure was<2%.Conclusions This study indicated that CBCT images can be used to make a treatment plan with its individual hounsfield unit-electron density calibration curve.

Objective To investigate the clinical and pathological features of eosinophilic diseases with cardiac involvement Methods We analyzed the clinical and cardiac pathological data of 7 patients with eosinophilic diseases with cardiac involvement under endomyocardial biopsy or autopsy.Results Seven patients (5 male, average age 51 years) were enrolled.Four patients were diagnosed as idiopathic hypereosinophilic syndrome and three were Churg-Strauss syndrome.Peripheral blood eosinophila count increased significantly in all patients.Cardiac involvement included angina pectoris, myocardial infarction, heart failure, presyncope and sudden death.Electrocardiogram showed cardiac ischemia, bundle branch block and third degree atrioventricular block.Echocardiography suggested ventricular and atrial enlargement, decreased ventricular systolic function, pulmonary hypertension, valvular prolapse and insufficiency and endocarditis.Pathology displayed infiltration of eosinophils, formation of granulomata, necrotizing vasculitis, myocardial necrosis and endomyocardial fibrosis in heart.Coronary artery could be also affected and led to myocardial infarction.Conclusions Cardiovascular complications of eocinophilic diseases are a major source of morbidity and mortality in these disorders.The manifestations are multiple and early recognition and treatment with steroid and immunosuppressant can improve prognosis.

ObjectiveTo investigate the in vivo biological performance of 5 porous bioceramic scaffolds,which were bioglass,β-tricalcium phosphate (β-TCP),hydroxyapatite (HA),β-calcium silicate (β-CS) and α-CS,implanted in rabbit dorsal muscle.MethodsThe 5 porous bioceramic scaffolds were fabricated by adding pore-forming materials and sintering,and then were investigated by X-ray diffraction,porosity mensuration and biomechanics test.The scaffolds were implanted into rabbit dorsal muscle for 4,8,12,16 weeks,respectively.The samples were analyzed by X-ray,Micro-CT,histological analysis,scanning electron microscope (SEM) and energy dispersive spectrometer (EDS).The expression of bone morphogenetic protein(BMP-2) and BMP-7 in the muscle in touch with bioceramic scaffolds were also investigated by polymerase chain reaction(PCR).ResultsThe characteristic analysis of 5 scaffolds showed that the sequence of compressive strength was bioglass＞α-CS＞β-CS＞β-TCP＞HA,the sequence of elasticity modulus was α-CS＜β-TCP＜HA＜β-CS＜bioglass.It was confirmed by X-ray,Micro-CT and histological analysis that the sequence of biodegradability was β-CS＞α-CS＞β-TCP＞bioglass＞HA.The histological observation showed no new bone formation in five scaffolds.A Ca-P layer was formed in the surface of bioglass,α-CS and β-CS,which suggested their in vivo bioactivity.After 16 weeks,the expression of BMP-2 and BMP-7 was found only in β-CS.Conclusion The porous calcium silicate scaffold,which was promising for bone tissue engineering,was with good in vivo bioactivity and biodegradability,without in vivo osteoinductivity.

Objective:To explore the method and curative effect evaluation of repairing and rebuilding the long segmental bone defect after resection of long bone malignant tumors in adolescents.Methods:Reviewed our experience in 10 patients. Among them, 4 were male and 6 were female. The age was 10.2 years old (range, 6-16 years old). Including 7 cases of osteosarcoma, 3 cases of Ewing's sarcoma; 2 cases of humerus tumors, 7 cases of femoral tumors, and 1 case of tibial tumors-who presented between April 2015 and October 2019, in which the proportion of bone defect account for 71.4%-89.3% of the total length of diseased bone after tumor resection, with an average value of 80.9%. Considering the epiphyseal growth of young people, on the premise of ensuring enlarged tumor resection, we use traditional fibula autograft and prosthesis combined with steel plate, 3D printing design to retain the super-prosthesis of the epiphysis, and 3D printing bone trabecular was processed for the sake of making it grow successfully into the binding part of prosthesis and bone as we expect, simultaneously, the design of the short-force arm retaining the bilateral epiphysis can assit the steel plate and interlocking screws to enhance the stability.Results:The operation was completed successfully, and there were no complications such as nerve and blood vessel injury during the operation. After follow-up of 4-8 months, with an average follow-up of 22.9 months. One patient's review of X-ray film after 2 years of the operation showed that the transplanted fibula had a sign of bone resorption, and the internal fixation was in it's original position without obvious abnormalities. Two cases' auxiliary steel plates had fractured within one and a half to two years after surgery. With replacing the fractured steel plates, the internal fixation was good until now. According to the evaluation standards of the International Society of Limb Salvation: 2 cases of humerus osteosarcoma were respectively scored 23 points, 26 points, an average of 24.5 points; 4 cases of femoral osteosarcoma and 3 cases of femoral Ewing's sarcoma respectively scored 26 points and 25 points, 19 points, 30 points, 27 points, 24 points, 28 points (average, 25.6 points); 1 case of tibial osteosarcoma scored 26 points; all obtained relative satisfying treatment results.Conclusion:The combination of 3D printing and traditional machining techniques to produce an individualized long segmental prosthesis that preserves the epiphysis which applicated in the limb salvage treatment of bone malignant tumors can achieve excellent therapeutic effect.

Gaucher′s disease (GD) is a lysosomal storage disease, and the etiology of GD is the decreased activity of glucocerebrosidase, which leads to the accumulation of glucocerebroside in the lysosomes of macrophages. Because GD is rare and lacks specific clinical manifestations, it is easy to be misdiagnosed, which delays the best time for treatment. Early diagnosis, clinical evaluation, and regular monitoring of the disease have important clinical significance for enzyme replacement therapy in patients with GD. Recent studies have found that radionuclide imaging is playing an increasingly important role in the diagnosis and treatment of GD. This article introduces the application of radionuclide imaging in the diagnosis and management of GD.