Purpose: To review radiotherapy for Grave's ophthalmopathy. Materials and Methods: From 1964 through 1992, 94 patients with Grave's Ophthalmopathy (4 unilateral and 90 bilateral lesions) were treated by radiotherapy with the doses of 9～25Gy. Results: The overall effective rate was 83%. Edema of the eyelid , proptosis and ophthalmalgia were significantly improved. No complication of pituitary gland was found for patients whose pituitary glands were involved in the radiation ports. Conclusion: Radiotherapy is effective for Grave's Ophthalmopathy. The radiation dose advised is 20～25Gy/3wks.

Objective To study the value of laparoscopic cholecystectomy (LC) for treating gallbladder benign diseases in aged patients. Methods Laparoscopy cholecystectomy (3-port or 4-port) was performed in 2335 senile patients with gallbladder benign diseases from December 1992 to May 2005. Results Five patients were found as having the Mirizzi syndrome and were given a subtotal cholecystectomy. In 18 patients with a frozen Callot’s triangle, the anterior wall of the gallbladder was resected and the mucous membrane on the posterior wall was electrocauterized. LC was completed smoothly in the remaining 2312 patients. No conversions to open surgery were needed. The operation time was 8~55 min (mean, 19 min), and the intraoperative blood loss was 1~ 50 ml (mean, 8 ml). An abdominal drainage tube was placed in 213 patients, including double-cannula lavage in 56 patients. The length of hospital stay was 4~16 d (mean, 6 d). Follow-up examinations for 10 days ~13 years in 1859 patients showed no biliary stenosis, gallbladder pouch, or residual stones. Conclusions Laparoscopic cholecystectomy is safe and feasible in aged patients, being the first choice of operative method. Proper perioperative management, careful prevention co-morbidities, and control of operation time as short as possible are important for senile patients.

Objective:To evaluate mental health status of medical students and to explore its related factors.Methods:877 medical students were tested by Symptom Checklist(SCL-90),Simplified Coping Style Questionnaire(CPS),and the stressful events items;240 of them were tested by Eysenck Personality Questionnaire (EPQ).Results:①Compared with the SCL-90 norm of youth group,medical students had higher scores ( P

Objective To explore family environment,parenting style,and personality of the patients with internalizing and externalizing mental disorders.Methods 137 adolescents with internalizing mental disorder(IMD),63 adolescents with externalizing mental disorder(EMD) and 228 normal subjects (control group) were investigated with Family Environment Scale-Chinese Version (FES-CV),Family Upbringing Style Questionnaire (FUSQ) and the NEO Five Factor Inventory (NEO-FFI).Results (1) The IMD group scored significantly lower on the cohesion (6.17 ± 2.68),active recreational orientation (3.84 ±2.50),moral-religious emphasis (4.48± 1.65),organization (5.35±2.30),expressiveness (4.60±2.00),achievement orientation (5.31 ± 1.84),and higher on the conflict (4.01 ± 2.38) than control group (P＜ 0.05).The EMD group scored only higher on the conflict (4.01±2.38) than control group (P＜0.05).(2) The all dimensional scores(apart from the parent's expect-demanding) of the IMD group were significantly lower than that of control group on the FUSQ (P＜0.05).The scores on the mother's democracy-authoritarian,parent care-protect,catholic-indulgences,parental-control,and expect-demanding were significantly lower in the EMD group than those in the control group (P＜0.05).(3) Relative to the control group,the IMD group got lower scores on the agreeableness (42.02±5.01),conscientiousness (38.91±8.01),and extraversion (35.17±8.57),and higher score on the neuroticism (40.10±8.55);the EMD group got lower scores on the agreeableness(42.75±5.12),conscientiousness (39.95±8.27) and openness (40.00±6.75).Conclusion Adolescents with mental disorders are living in conflict and discord family environment,feel more negative parenting such as authoritarian,harsh,indulgence,control,and demanding,and show some unhealthy personality such as low agreeableness,low conscientiousness,and high neurotic.

ObjectiveTo clone and express the Tp0136 gene of Treponema pallidum,to purify the recombinant protein and to evaluate its immunocompetence.MethodsThe full-length Tp0136 gene was synthesized,then subcloned into the expression vector pET28a to construct a recombinant plasmid,pET28a-Tp0136,which was subsequently transfected into E.coli Rosetta for protein expression.The recombinant protein was purified with nickel-nitrilotriacetic acid(Ni-NTA) affinity chromatography,and identified by using sodium dodecyl sulfate polyacrylamide gel electropheresis (SDS-PAGE) and Western blot.New Zealand rabbits were immunized with the recombinant Tp0136 (rTp0136)protein,and anti-Tp0136 polyclonal antibodies in sera of the rabbits were examined by indirect enzyme linked immunosorbent assay(ELISA) with rTp0136 protein as the coating antigen.Also,positive sera were obtained from patients with syphilis and examined by Western blot to identify the immunoreactivity of the rTp0136 protein.ResultsThe E.coli expression vector pET28a-Tp0136 was constructed successfully,and rTp0136 protein was also successfully expressed with a molecular weight of about 50 kD and a purity above 95％.High titres of anti-rTp0136 antibodies were detected in sera of rabbits immunized with the rTp0136 protein,and Western blot showed that the rTp0136 could specifically react with the sera from syphilitic patients,which proved the high immunogenicity and immunoreactivity of the recombinant protein.ConclusionsThe full-length Tp0136 membrane protein is successfully expressed with a high immunocompetence,and Tp0136 membrane protein may play an important role in the pathogenic mechanisms of Treponema pallidum.

Objective To evaluate the lower urinary tract symptoms(LUTS)after Drostate cancer brachytherapy. Methods 122 patients with prostate carcinoma underwent125 I seed implanta-tion.All patients were at clinical stage Tl.N0 Mo-T3.N.Mo with Gleason score 5 to 9,serum PSA 0.9-65.Ong/ml,prostate volume 12 to 57m1.30-86 seeds were implanted bv 16-28 needles with seed activity 1.11-1 9.6 MBq mci,total seed activity 444-1 5 9 1 MBq. International prostate symp-tom score(IPSS)ranged from 3 to 19,with mean of 12.All the patients received d-blocker and 106 cases(86.9%)received androgen deprivation therapy(ADT). Results Patients were foilowed up for 3-34 months(mean 21 months).Acute urinary retention was found in 8 cases(6.6%)and mild urina-ry incontinence was found in 10 cases(8.2%).During the follow-up,107(87.7%)of them had LUTS or LUTS symptoms aggravated.Percentage of patients with LUTS after brachytherapy at different time point were as follow:15 d,16.4%;1 month,80.3%;2 months,81.2%;3 months,74.6%;6 months,42.0%;9 months,25.2%;12 months,18.5%;15 months,11.5%;18 months,7.4%;21 months,2.5%;24 months,3.3%and 30 months,O%.Larger prostate volume and higher IPSS before brachytherapy were correlated with LUTS lasting time.Simple linear regression analyses re-vealed prostate volume(r=0.281,P=0.003)and IPSS(r=0.254,P=0.012)before brachytheraDy to be significant predictors of LUTS period respectively. Conclusion IUTS after prostate cancer brachytherapy is common and long lasting,but not serious,which could be relieved by mblockers and ADT.

Objective To evaluate the feasibility and significance of CT image-based threedimensional (3D) brachytherapy for cervical cancer.Methods Three-dimensional (3D) plan and twodimensional (2D) plan were designed for 55 CT images of brachytherapy from 12 cervical cancer patients who received radical radiotherapy in 2013.Dosimetric comparison was performed between the 3D plan and 2D plan,and paired t-test,Wilcoxon signed rank test,Pearson correlation analysis,and Spearman correlation analysis were performed.Results A point dose,D90,V100,CI,and CI' in 3D plan were higher than those in 2D plan (P=0.015,0.016,0.000,0.000,0.000).Bladder point dose,rectal point dose,and rectal D2 cm3 in 3D plan were slightly higher than those in 2D plan,but hot spot dose was significantly reduced in 3D plan (P =0.140,0.123,0.214).Bladder D2cm3 was significantly higher than bladder point dose (P =0.000).Sigmoid colon D2cm3 was more correlated with the average doses of the three highest rectal points than rectal D2 cm3 (r =0.314,0.630,P =0.000,0.000).V100 showed a linear relationship with high-risk CTV (r =0.981,P =0.000).Bladder D2cm3 was higher than 430 cGy when the bladder volume was more than 80 cm3 ;small intestinal D2 cm3 did not change significantly when the bladder volume was less than 115 cm3,but decreased significantly once the volume exceeded the value.Conclusions Compared with the traditional 2D plan,the 3D plan for CT image-based cervical cancer brachytherapy significantly increases the target coverage and conformity index,but does not significantly increase the doses to organs at risk.Point dose evaluation is confirmed to be inaccurate.The doses to the bladder,rectum,and small intestine can be adjusted by controlling the bladder volume.

Objective To study the image quality control system to ensure that equipment meet clinical needs.Methods It was scanning the Catphan504 phantom with models of high quality head,standard dose head and pelvis,we could get the results of CT numbers linearity,uniformity,spatial resolution,contrast resolution.Using T test to compare different scanning technique results.Results The standard dose head scanning technique was better than the pelvis scanning technique in CT numbers linearity test,and gets the best result in uniformity test.The result of CT numbers uniformity was higher in the standard dose head scanning than the high quality head and the pelvis scanning (9.7 ±3.9 vs.17.9 ±5.3,P =0.00 and 9.5 ± 4.0 vs.31.1 ± 5.7,P =0.00).The result of contrast resolution was higher in the pelvis scanning than the high quality head and the pelvis scanning (5.6 ± 0.1 vs.1.3 ± 0.5,P =0.00 and 6.0 ± 1.0 vs.1.3 ± 0.5,P =0.00).The result of spatial linear distance was very accurate,the range was 4.98 -5.06 cm.Conclusions The results of spatial linearity test are stable and accuracy,but CT numbers linearity and uniformity test are affected by the scanning technique significantly for device.To spatial resolution test and contrast resolution test,we need to set the standard and tolerance according to each linear accelerator specialty.

Objective To study the dosimetry characteristics of 9 equal spaced fields and 9 fields with beam angle optimization (BAO) process for cervix uteri.Methods 12 cervix uteri cancer patients CT Images were transferred into Eclipse planning system.Each patient,the 9 equal spaced fields and 9 fields by BAO process were IMRT plan designed with the same CT image.Make a evaluation of dose distribution for target volume and OARs,and paired t test for them.Results Comparing to 9 equal spaced fields IMRT plan,the quality of 9 fields IMRT plan with BAO process the the PTV V95％ was 99.31％ vs 99.42％,P =0.020,at the same time V105％,V110％,Dmax,D got 60.54％ vs 47.92％,P =0.013;7.14％ vs 0.37％,P =0.000;56.62 Gy vs 55.47 Gy,P =0.000;53.29 Gy vs 52.72 Gy,P =0.000,the CI and HI was 0.85 vs 0.89,P =0.000 ;0.10 vs 0.13,P =0.000.For organs at risk,bladder V40 was increased by 4.7 ％ (P =0.013) ;the D40 of rectum was 0.5 Gy higher (P =0.004) ; the small bowel's DVH showed that V40 and Dmax increased by 0.6％ (P =0.015) and 1.4 Gy (P =0.000),D of bone marrow were raised separately by 1.3 Gy (P =0.000),the spinal cord's dose D0.1 cm3 was also increased by 2.0 Gy (P =0.000).Conclusion The quality of 9 equal spaced fields IMRT plan will be better than those achieved by BAO process optimized plans.

Objective To study the influence of quedcetin on the collagen synthesis of cultured fibroblasts and to explore the mechanism.Methods The inhibitory effect of quercetin and radiation on fibroblast proliferation was assayed using MTT assay.Collagen synthesis was detected by hydroxyproline colorimetric analysis.Immunocytochemical staining method was used to investigate the expression of collagen Ⅰ and Ⅲ.The mRNA expression of typeⅠ,type Ⅲ collagens and TGF?-1 were assayed by reverse transcriptionpolymerase chain reaction(RT-PCR) and real-time PCR technique.Results Keloid fibroblast cell proliferation and collagen synthesis of fibroblasts were inhibited by quercetin in a dose-dependent manner.Significant inhibition was observed by the treatment with quercetin and radiation together.Immunocytochemical staining indicated the IOD of type I and Ⅲ collagen protein was down-regulated by quercetin and radiation.Both collagen Ⅰ and collagen Ⅲ gene in the quercetin groups showed a significantly decreased mRNA expression compared with that in the untreated group,especially in the group treated with both quercetin and X-ray.Procollagen gene expression was inhibited and then decreased type Ⅰ and Ⅲ protein syntheses of fibroblsts,particularly type Ⅰ procollagen gene(P