This study taking gestodene (GEST) as a model, investigated the factors affecting reservoir-type intravaginal ring (IVR)'s drug release. This paper reported a gestodene intravaginal ring of reservoir design, comprising a gestodene silicone elastomer core encased in a non-medicated silicone sheath, separately manufactured by reaction injection moulding at 80 degrees C and heating vulcanization at 130 degrees C is reported. The test investigated the factors affecting drug release through a single variable method, taking the drug release rates of 21 days as standards. When changing the thickness of the controlling sheath outside, the ratio of the first day of drug release and mean daily release (MDR), named the relatively burst effect, is closing to 1 with the thickness of controlling sheath increasing, while the 1.25 mm sheath corresponding to 1.04 controlled the burst release effectively; a positive correlation (r = 0.992 2) existed between the average drug release (Q/t) and drug loading (A) within a certain range. The C6-165 controlling sheath with high solubility of GEST is easier to achieve controlled release of the drug; GEST crystalline power is more effective to implement controlled release of drugs among difficent states of the drug. A 1/4 fractional segment core gives a relatively burst effect of 1.76, while the 1/1 and 1/2 are 1.93 and 1.87 separately, at the same drug loading, concluding that use of a fractional segment core would allow development of a suitable GEST reservoir IVR. In summary, GEST reservoir-type IVR could be adjusted by the thickness of controlling sheath, the loading of drug, the material properties of controlling sheath, the dispersion state of drug, the additive composition and structure of intravaginal ring, to control the drug release behavior and achieve the desired drug release rate.

Objective To study the correlation between dose-volummetrics and changes of pulmona- ry function tests(PFTs), and to study the ability of standard dose-volummetrics to predict these changes after radiotherapy. Methods Pulmonary function was measured in 39 patients with inoperable lung cancer one week before and 2-4 months after radiotherapy. The pulmonary function parameters were the forced vital ca- pacity(FVC), forced expiratory volume in ls (FEV 1.0) and diffusion capacity of carbon monoxide(DL- CO). Dose-volumrnetrics were V_(10), V_(15), V_(20), V_(25), V_(30), V_(35), V_(40), CTV_(100), CTV_(95), CTV_(90), CTV_(80), lung D_(mean), V_(eff) and NTCP. Pearson and line regression analysis was performed to determine whether the correlation exis- ted between the metrics and the changes of PFTs. Results No correlation was found between the dose- volummetrics and the changes in PFTs. Excluding patients(n=15) with pretreatment atelectasis, signifi- cant correlation was found between the dose-volummetrics (V_(20), V_(25), V_(30), V_(35), V_(40), GTV, V_(eff) and D_(mean)) and the PFTs changes(r=0.469-0.695, P≤0.05). Therefore, the re-expansion may have jesperdized the proper data to the present record. Multivariate analysis showed that V_(30) was the risk factor to affect the chan- ges of FEV 1.0 and DLCO(P=0.046、0.041). The pulmonary function of patients with V_(30)≥18% was worse than patients with V_(30)

ObjectiveTo observe the functional recovery of shoulder joint and the reduction of posterior dislocated humeral head in children with shoulder joint internal rotation contracture and humeral head posterior dislocation secondary to brachial plexus birth palsy treated by a modified surgical procedure through the anterior combined posterior approach of the shoulder. MethodsNinteen patients,ranging in age from 2.5 to 8.5 years (average 5 years),suffered posterior dislocation of the shoulder joint secondary to internal rotation contracture in brachial plexus birth palsy. The gleno-humeral joint deformity was confirmed by X-ray and CT examination and classified as type Ⅳ in 15 eases and typeⅤin 4 cases according to the modified water's criteria.The surgical procedure was as follows:the contracture soft tissue around the anterior of shoulder joint was released firstly through the anterior approach, and the posterior-inferior capsule of the shoulder was exposed and separated with the pseudoglenoid through the posterior approach,the humeral head was reduced by external rotation the arm,then the posterior-inferior capsule was retighten.A plaster cast was used to fix the shoulder at the neutral position of 0° for 4 weeks. ResultsAfter 12 to 36 months follow up(average of 20 months), the Mallet score of the shoulder was from 11.4 ± 1.7 (range 7-16)preoperative to 15.5 ± 1.8(range 13-19) postoperative,the difference was significantly (P ＜ 0.05).The central relocation of humeral head was achieved in 16 patients, but the humeral head was still dislocated to posterior in 3 cases.ConclusionsThe posterior-inferior capsule was separated with the pseudo-glenoid and retighten through the posterior approach,and reduction of the humeral head by soft tissue releaseing through the anterior approach can recover the concentric relationship of gleno-humeral joint and improve the function of shoulder joint with posterior dislocation secondary to internal rotated contracture deformity in brachial plexus birth palsy.

Objective With the Monte Carlo method to recaleulate the IMRT dose distributions from four TPS to provide a platform for independent comparison and evaluation of the plan quality.These results wiU help make a clinical decision as which TPS will be used for prostate IMRT planning.Methods Eleven prostate cancer cases were planned with the Corvus,Xio,Pinnacle and Eclipse TPS.The plans were recalculated bv Monte Cado using leaf sequences and MUs for individual plans.Dose-volume-histograms and isodose distributions were compared.Other quantities such as Dmin(the minimum dose received by 99% of CTV/PTV),Dmax(the maximum dose received by 1%of CTV/PTV),V110%,V105%,V95%(the volume of CTV/PTV receiving 110%,105%.95% of the prescription dose),the volume of rectum and bladder receiving>65 Gy and>40 Gy,and the volume of femur receiving>50 Gy were evaluated.Total segments and MUs were also compared.Results The Monte Carlo results agreed with the dose distributions from the TPS to within 3%/3 mm.The Xio,Pinnacle and Eclipse plans show less target dose heterogeneity and lower V65 and V40 for the rectum and bladder compared to the Corvus plans.The PTV Dmin is about 2 Gy lower for Xio plans than others while the Corvus plans have slightly lower female head V50(0.03%and 0.58%)than others.The Corvus plans require significantly most segments(187.8)and MUs(1264.7)to deliver and the Pinnacle plans require fewest segments(82.4)and MUs(703.6).Conclusions We have tested an independent Monte Carlo dose catculation system for dose reconstruction and plan evaluation.This system provides a platform for the fair comparison and evaluation of treatment plans to facilitate clinical decision making in selecting a TPS and beam delivery system for particular treatment sites.

Objective To explore the protective effect of creatine phosphate sodium and compound coenzyme on tumor children with Adriamycin(ADM)-induced myocardial injury.Methods From Feb.2012 to Feb.2014,there were 153 tumor children administered in Shijitan Hospital,the Capital Medical University,among which there were 112 male and 41 female,aged from 10 months to 5 years,and the median age was 2.3 years.All the cases were randomly divided into 3 groups,with the dose of ADM at 20-30 mg/(m2 · d) for 3 days,and for 3 to 6 courses of treatment.All cases were rolled in the ADM chemotherapy:group A,intravenous infusion of creatine phosphate sodium(1.0 g/d) and compound coenzyme(1 injection/d),at a total of 7 days;group B with only intravenous infusion of creatine phosphate sodium(1.0 g/d) for a total of 7 days;group C with only intravenous infusion compound coenzyme(1 injection/d) for a total of 7 days.Two days before ADM chemotherapy,creatine phosphate sodium and / or compound coenzyme were administrated to protect the musculus cardiacus.One day before chemotherapy and two days after chemotherapy,the peripheral blood was taken to determine levels of malondialdehyde (MDA),creatine kinase (CK),creatine kinase MB (CK-MB),cardiac troponin(cTnT),N terminal pro-brain natriuretic peptide(NT-proBNP),high-sensitivity C-reactive protein(hsCRP),electrocardiogram,echocardiogram and so on.Then the changes of all those indicators before and after the chemotherapy between the groups were compared.Results The morbidity of myocardial damage induced by ADM was increased significantly with its dose accumulation (x2 =18.462,P ＜ 0.05).Creatine phosphate sodium combined with compound coenzyme could decrease the morbidity of myocardial damage induced by ADM (x2 =4.883,5.971,all P ＜ 0.05).Compared with those before chemotherapy,the cTnT (t =2.561,P ＜ 0.05),NT-proBNP (t =6.654,P ＜ 0.01) and hsCRP(t =3.149,P ＜ 0.01) levels of group A decreased markedly.Serum levels of MDA (t =2.170,P ＜0.05),CK-MB(t =2.596,P ＜0.05) and hsCRP(t =2.604,P ＜0.05) of group B increased obviously.Serum levels of MDA (t =2.151,P ＜ 0.05) and CK-MB (t =4.109,P ＜ 0.05) of group C also increased obviously.After chemotherapy,the detection of serum indexes of all groups showed as below.Contracted with those of group A,the serum MDA(t =4.461,P ＜ 0.01),CK-MB (t =3.273,P ＜ 0.01),cTnT (t =3.476,P ＜ 0.01),NT-proBNP (t =7.081,P ＜ 0.01) and hsCRP(t =5.941,P ＜ 0.01) levels of group B increased distinctly.Meanwhile,the MDA (t =4.064,P ＜0.01),CK-MB(t =5.452,P ＜0.01),cTnT(t =2.768,P ＜0.05),NT-proBNP(t =4.806,P ＜0.01)and hsCRP(t =3.436,P ＜ 0.05) levels of group C also increased significantly.Conclusions Both creatine phosphate and compound coenzyme could reduce the myocardial damage induced by ADM.Combination of them has important clinical value for better prevention of cardiac toxicity of ADM,enhancement of the prognosis of childhood tumor,and improvement of the long-term quality life of those children.

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.

AIM To investigate the activation of p38 protein kinase in alveolar macrophages(AMs) stimulated with lipopolysaccharide(LPS) and the effects of dexamethasone(DEX) and N acetylcysteine(NAC) on the process. METHODS AMs isolated and purified from normal rats were divided into four groups:Control group, LPS stimulated group ,DEX group and NAC group. The activation of p38 protein kinase in nuclear protein extract from the AMs and the concentration of TNF ? and IL 8 in supernatant were measured by Western blot and radioimmunoassay, respectively. RESULTS The activation of p38 protein kinase and the concentration of TNF ?, and IL 8 in LPS stimulated group were significantly higher than those in control group( P

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 investigate the choise of operation approach for chronic otitis media surgery. METHODS Auditory and high resolution computed tomography (HRCT) assessment were carried out prior to the operation in 160 ears with otitis media. Tympanoplasty or mastoidectomy and tympanoplasty were performed. RESULTS Thirty-one patients received tympanoplasty and 129 patients received mastoidectomy and tympanoplasty. Closed and opened surgery were performed in 49 and 80 cases respectively. The ear-drying time ranged from 7 to 51days with an average of 23 days. Mean hearing increased by 15dB. CONCLUSION Assessing the HRCT scan prior to the surgery can help us choose a reasonable approach in chronic otitis media surgery.

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.