ObjectiveTo measure the setup errors with infrared marker-based positioning system (IM-BPS) and electronic portal imaging device (EPID) for patients with esophageal carcinoma and lung cancer and investigate the accuracy and practicality of IM-BPS. MethodsFrom January 2007 to January 2008, 40 patients with esophageal carcinoma and 27 patients with lung cancer received three-dimensional conformal radiotherapy or intensity-modulated radiotherapy, setup errors during the treatment were measured with IM-BPS and EPID, and the data of setup errors were compared with paired t-test and agreement with x2-test. ResultsIt takes 10 - 12 mins to complete the validating for each patient by EPID) system, while IMBPS system only needs 2 -5 mins. The mean setup errors along x, y and z-axis for patients with esophageal carcinoma measured by IM-BPS and EPID were 3.49 mm, 3. 19 mm, 3.31 mm and 4. 03 mm, 3.41 mm, 3.43 mm, respectively. For the patients with lung cancer, the setup errors were 4. 23 mm, 3.51 mm, 3. 39mm and 4. 85 mm, 3. 53 mm, 3.74 mm, respectively. The difference of setup errors meanured by the two systems was within 1 mm for 65％ esophageal carcinoma patients ( x2 =51.09, P =0. 000), and 55％ lung cancer patients ( x2 =53. 35, P =0. 000).Conclusions The measurement results of setup errors for patients with esophageal carcinoma and lung cancer show that IM-BPS is mostly better than EPID. Though validating for patients can be measured accurately and be well quality controlled, IM-BPS is used easily because of macroscopic, homely,spare time and real-time monitoring.

Objective To explore the histological changes of the wrist interosseous ligaments after radiofrequency electrothermal shrinkage. Methods Six frozen fresh male adult cadaver wrist ligaments were exploited for the research. The ligaments of the right wrists were treated with radiofrequency electrothermal shrinkage with Arthrocare system, while the ligaments of the left wrists were kept as the normal control. The bone-ligament-hone samples of all the scapholunate (SL) and lunotriquetral (LT) ligaments were prepared, sectioned and then stained with the regular HE staining, toluidine blue staining, Sirius-red staining and immunohistochemistry staining of collagen Ⅲ. The image analysis software was used to compare the staining results. Results The histological structures of SL dorsal ligaments (SL-d) and LT volar ligaments (LT-v) were very similar, and the structures of SL volar ligaments (SL-v) and LT dorsal ligaments (LT-d) were also very similar. The membrane parts of both SL and LT ligaments showed the fibrous cartilage structure. The histological structures of SL-d and LT-v were much less destroyed by the radiofrequency than those of SL-v and LT-d. After radiofrequency electrothermal shrinkage, only the distribution areas of collagen Ⅰ and collagen Ⅲ were significantly changed in the membrane parts of SL and LT ligaments. Conclusion Radiofrequency electrothermal shrinkage treatment can cause minor structural damage to the collagen-dominant ligaments such as SL-d and LT-v, while it can lead to quite severe structural damage to the ligaments containing collagen and lots of loose connective tissue, such as SL-v and LT-d.

Objective To measure the setup errors and organ movements of patients with esophagus carcinoma during radiotherapy and find a reasonable margin from the clinic target volume (CTV) to the planning target volume (PTV). Methods (1) Set-up veri cation: Forty-two cases of untreated esophageal cancer were enrolled into this study. The physicist firstly made the planning according to the doctor requests and ensured the best distribution at the target. Thereafter, the 0° and 90° digitally reconstructed radiograph (DRR) was transmitted to the iView GT workshop. Meanwhile, two copies of cross-cut electronic portal image (EPI) were required before radiotherapy. Two doctors confirmed the variance of the osteal mark from the EPI and DRR,and output a 3D direction (left to right, superior to inferior, anterior to posterior) of the setup errors through the iView GT software. (2)Breathing motion:Ten cases of untreated esophageal cancer were enrolled into this study.Three distinct breathing levels were deflned: FB (free breathing), EBH (expiration with breath-held) and IBH (inspiration with breath-held). We gave the treatment planning in FB, then by moving the isocenter to EBH and IBH, we recalculated the dose distribution without changing the field angle, shape and weighing (Mus). Displacements were analyzed at four points (anterior, posterior, right lateral and left lateral) and five levels of target (upper, quarter, isocenter, three-quarter and lower). Results (1) The systematic setup errors were -0.23 cm, -0.02 cm and -0.06 cm, and the random errors were 0.44 cm, 0.45 cm and 0.44 cm at the direction of left to right(LR), superior to inferior (SI), anterior to posterior(AP), respectively. (2) The organ movements were 0.3 cm, 0.6cm and 0.3cm at the LR, SI, AP, respectively. Conclusions As an alternative, the root-sum-of-squares of set-up error and organ motion are suggested by σtot=√ (σITV2+σSM2). The CTV to PTV margins are 0.8cm left to right, 0.78cm superior to inferior, 0.5cm anterior to posterior.

OBJECTIVE:To prepare mesopocous molecular sieve SBA-15 surface molecularly imprinted polymer (SBA-15@MIP),and analyze the application of SBA-15@MIP in the determination of active micro-component. METHODS:Using baica-lein as the template molecule,acrylamide(AM)as the function monomer,tetrahydrofuran/ethanol(3∶2,V/V)as the polymeriza-tion solvent,ethylene glycol dimethacrylate(EGDMA)as the cross-linker,and 2,2-azobisisobutyronitrile(AIBN)as the initiator, SBA-15@MIP was synthesized on the surface of mesopocous molecular sieve SBA-15. The surface morphology and structure of the obtained polymer were characterized by TEM and FT-IR. Finally,the imprinted polymer was used as an adsorbent for solid-phase extraction (SPE) to detect baicalein in plasma samples by HPLC. RESULTS:It revealed that the well-ordered one-dimensional pore structure of SBA-15 was still preserved in the successful synthesized SBA-15@MIP,and baicalein molecule was imprinted suc-cessfully. The limit of detection(LOD)and limit of quantification(LOQ)for baicalein in plasma were 3.5 ng/ml and 11.6 ng/ml, respectively;the average recovery was 94.4%(RSD=2.9%). CONCLUSIONS:SBA-15@MIP is prepared successfully,and can be applied for the determination of active micro-component.

AIM: To observe the supplementation action of the crude and processed Epimedium Sapittatum Maxim. METHODS: The effects of different extracts of Epimedium Sagittatum Maxim. on the castrated mice were observed. RESULTS: The aqueous and alcohol extracts of the crude and processed Epimedium Sagittatum maxim. showed same marked inhibition on atrophy of castrated mice. CONCLUSION: The crude and processed Epimedium Sagittatum maxim. both have the supplementation action and show no marked difference in action.

Objective To study the relationship between parameter settings in the intensity-modulated radiation therapy (IMRT) planning in order to explore the effect of parameters on absolute dose verification.Methods Forty-three esophageal carcinoma cases were optimized with Pinnacle 7.6c by experienced physicist using appropriate optimization parameters and dose constraints with a number of iterations to meet the clinical acceptance criteria.The plans were copied to water-phantem,0.13 cc ion Farmer chamber and DOSE1 dosimeter was used to measure the absolute dose.The statistical data of the parameters of beams for the 43 cases were collected,and the relationships among them were analyzed.The statistical data of the dosimetry error were collected,and comparative analysis was made for the relation between the parameters of beams and ion chamber absolute dose verification results.Results The parameters of beams were correlated among each other.Obvious affiliation existed between the dose accuracy and parameter settings.When the beam segment number of IMRT plan was more than 80,the dose deviation would be greater than 3％ ; however,if the beam segment number was less than 80,the dose deviation was smaller than 3％.When the beam segment number was more than 100,part of the dose deviation of this plan was greater than 4％.On the contrary,if the beam segment number was less than 100,the dose deviation was smaller than 4％ definitely.Conclusions In order to decrease the absolute dose verification error,less beam angles and less beam segments are needed and the beam segment number should be controlled within the range of 80.

Objective To evaluate the respiration-induced dosimetric variance in 3DCRT for midthoracic esophageal carcinoma, in order to guide the radiation oncologist to choose the expansion margin. Methods Ten patients with mid-thoracic esophageal carcinoma were scanned by multi-spiral CT simulator respectively in free breathing ( FB), breath-hold after normal inspiration and expiration ( IBH and EBH )with the same scanning range. Then the CT images of three series were transferred to the treatment planning system. The target volume was outlined following the same standard. Plan1 was designed in the images of FB and transported completely to the images of IBH and EBH as Plan2 and Plan3 respectively to observe the dosimetric variance in target volume. Results For GTV, there was a statistical difference only in V100 of the three plans ( H = 6.423, P = 0.040 ) and no significant difference was found in other indexes. For CTV, the V100 and V95 were better in Plan1 (F=3.992, P=0.030; H=9.920, P=0.007) and no significant difference was found in other indexes. While ()TV, the Dmin, V100 and V95 was better in Plan1 ( F = 3.677, P = 0.039; F = 4.539, P = 0.020; H = 6.846, P = 0.033 ) and no significant difference was found in other indexes. There were no significant differences in all the indexes for the spinal cord and lung in the three plans. Conclusions The change in dose distribution was not so much with the standard expansion. It can meet the needs of clinical treatment.

Objective:To evaluate the correlation of inter-individual variation of cyclosporine dosage and blood concentration and CYP3A4 and CYP3A5 polymorphism in renal transplant recipients. Methods:Two hundred and twenty-one renal transplant recipients treated with cyclosporine were genotyped for CYP3A4 rs4646437C>T and CYP3A5 6986G>A using ligase detection reactions. The effects of genetic polymorphisms of CYP3A4 and CYP3A5 on cyclosporine trough concentration (C0/D) and 2 h post-dose concentra-tion (C2/D) during the period of 6 months, 6-24 months and above 24 months after renal transplant were studied. Results:CYP3A5 6986G>A genotype affected C0/D during the period of 6 months, 6-24 months and beyond 24 months (P<0. 05) with the order of CYP3A5 6986GG>GA>AA. CYP3A4 rs4646437C>T and CYP3A5 6986G>A genotype affected C2/D during the period above 24 months (P<0. 05) with the order of CYP3A4 rs4646437 CC>CT>TT and CYP3A5 6986GG>GA>AA. Conclusion: CYP3A5 6986G>A genotype affects C0/D and C2/D of cyclosporine, and CYP3A4 rs4646437 C>T genotype affects C2/D of cyclosporine. The effects of genotypes are varied in different stages.

Objective To study the relationship between radiation gastritis ( RG ) caused by esophageal cancer radical postoperative prophylactic IMRT and the dose of gastric. Methods A total of 49 esophageal cancer patients received postoperative adjuvant radiatherapy after esophagectomy, we analysised the dose?volume histogram of treatment plan and the the occurrence of RG, To analysis those physical indicators may be related to the occurrence of RG. The of ROC curve to analysis the physical index of the occurrence of acute radiation gastritis, Chi square test is compared between groups, Logistic method was used to multivariate analysis. Results The whole group, a total of 19 cases ( 39%) patients with symptoms of acute RG level 2 or higher. The results of ROC curve analysis showed that the physical variables associated with the occurrence of RG include stomach Max,stomach Mean,LSTT5?LSTT40 and V5?V50.According to the ROC curve,the cutoff values of the physical parameters of the patients were grouped. The incidence of acute≥2RG in the group of above boundary value patients significantly higher than below boundary value group, the physical index of the differences between groups were significant (P=0. 000?0. 022),except V5.The results of Logistic multivariate analysis showed that LSTT5 and V40 were independent predictor of≥2 RG (P=0. 026,0. 001). Conclusions According to the results of this study,We should pay attention to the protection of the stomach in develop a treatment plan for the prevention of postoperative patients with esophageal cancer,dose?volume histogram can well predict the occurrence of RG. Stomach LSTT5 and V40 were independent predictor of≥2 RG.The results of this study need to be further studied.

Objective To observe the outcomes of the modified multiple nerve transfer s combined with the late hand function reconstruction to restore the active pick-up function of the paralyzed upper extremity in patients with total brachial plexus avulsion injuries (TBPAI).Methods 33 patients suffered with TBPAI firstly underwent multiple nerve transfers,which including accessory nerve transfers to neurotize the suprascapular nerve to recover the shoulder abduction,contralateral C7 (CC7) nerve transfers via the modified pre-spinal route with direct coaptation to restore lower trunk function and the musculocutaneous nerve was also neurotized by the transferred CC7 nerve via a cutaneous nerve graft to restore the function of elbow flexion,as well as the phrenic nerve transfers to neurotize the posterior division of lower trunk to restore the function of elbow and finger extension.The patients with muscle recovery were selected to perform the hand function reconstruction at the second stage for restoring the active pick-up function.The patients were chosen as followcriterias:the degree of shoulder abduction attained 30°or more,the motor power of elbow,wrist,and finger flexion attained grade M4 or more,elbow and finger extension attained M3 or more.The methods of hand function reconstruction included wrist fusion and flexor carpal ulnaris opponensplasty,in addition to palmar capsulodesis of the metacarpophalangeal joint.Results The mean follow up was 41±7.7 (range,36-73 months) after the first procedure of multiple nerve transfers,the muscle strength of elbow and finger and wrist flexion attained M 4 as well as the elbow and finger extension achieved M3 or more in 10 patients,all of 10 patients achieved 40°-80°shoulder abduction.8 out of 10 patients had performed the second surgical procedure for hand functional reconstruction.6 of them had successfully recovered the active pick-up function.Conclusions The newly designed procedure of multiple nerve transfers could effectively restore the function of shoulder abduction,elbow,wrist,and finger flexion,as well as elbows and finger extension in patients with TBPAI,combined with the hand functional reconstruction,active pick-up function could be successfully reconstructed.