Objective To investigate the feasibility and plan quality of the image-guided volumetric modulated arc therapy (VMAT) based voluntary deep exhale breath-holding technique in the stereotactic ablative body radiotherapy (SABR) for liver tumors.Methods Fifteen patients with liver tumors were involved in this study.All patients were immobilized with voluntary deep exhale breath hold (vDEBH) combined with real-time position management (RPM) respiratory gating system.Treatment was planned using VMAT with 2 modified partial arc and re-planned using intensity modulated radiation therapy (IMRT) technique for comparison.Dosimetric parameters were calculated for plan quality assessment.Quality assurance studies included absolute dose and multiple planar dose verifications,total monitor units and delivery time analysis.Daily cone beam computed tomography imaging was used to verify the motions.Results There were no significant dosimetric differences between VMAT and conventional IMRT plans (P ＞0.05).Both techniques were able to minimize doses to organs at risk including normal liver,kidneys,spinal cord,and stomach.However,the average monitor units with VMAT were significantly lower 28.1％ than those with IMRT(t =3.064,P ＜0.05).The average beam-on time in VMAT plans was 31.6％ shorter than that in IMRT plans(t =2.278,P ＜ 0.05).Conclusions The utilization of VMAT in the treatment planning of SABR for liver tumors under breath control mode has better dosimetrics.In comparison to conventional IMRT plans,VMAT plans have higher efficiency and feasibility.

Objective:To evaluate the value of improved pulmonary ultrasonography in the follow-up assessment of lung damage in patients who recovered from corona virus disease 2019(COVID-19).Methods:Twenty-two patients who were cured of COVID-19 in Quanzhou First Hospital from January to May 2020 were randomly selected and divided into 7 mild cases, 12 moderate cases and 3 severe cases according to the first high-resolution CT (HRCT) at admission. Six months after recovery, modified lung ultrasonography and HRCT were used prospectively to assess the lung damage and evaluate the correlation and consistency between the two techniques.Results:①There were significant differences in lung damage between the mild group and the moderate group, severe group (all P<0.05), while there was no significant difference between the moderate group and severe group ( P>0.05). ②There was good consistency between the improved lung ultrasound examination and HRCT (Kappa=0.776, P<0.001). ③There was a positive correlation between the score of improved pulmonary ultrasound examination and HRCT Warrick score ( r=0.755, P<0.001). Conclusions:Improved pulmonary ultrasonography can be used as a priority in the evaluation of pulmonary damage follow-up in patients with COVID-19 recovery, reducing the use of CT, and providing favorable evidence for further clinical management.

OBJECTIVETo investigate the relationship between the resistance index (RI) of the renal artery and serum creatinine (Cr) level in patients early (within one month) after renal transplantation.

METHODSA total of 123 patients receiving renal transplantation underwent examinations by color Doppler ultrasound for measurement of the RI of the renal artery within one month after the operation. According to the results of RI measurement, the patients were divided into RI≥0.75 and RI<0.75 groups for analyzing the correlation between RI and serum Cr level measured at the same time points.

RESULTSThe RI and Cr levels in patients with RI≥0.75 showed a significant positive correlation (P<0.05), whereas they showed an inverse correlation in patients with RI<0.75 (P<0.05). The patients with RI≥0.75 had significantly lower RI of the renal artery and Cr level than those with RI≥0.75.

CONCLUSIONRI is significantly correlated to Cr, and may serve as an indicator for predicting renal graft function after transplantation.

Adolescent ; Adult ; Aged ; Creatinine ; blood ; Female ; Humans ; Kidney Transplantation ; Male ; Middle Aged ; Postoperative Period ; Renal Artery ; diagnostic imaging ; physiopathology ; Ultrasonography, Doppler ; Vascular Resistance ; Young Adult

OBJECTIVETo study the effects of modified Huopo Xialing Decoction (HXD) in treating patients of Pi-Wei dampness-heat syndrome (PWDHS) and its impact on epithelial cell apoptosis of tongue.

METHODSFifty patients with PWDHD were randomized depending on their visiting sequence into two groups, the 30 patients in the treatment group treated with HXD and the 20 in the control group treated with Domperidone. The therapeutic course for both groups was 2 weeks. Besides, a normal control group consisting of 30 healthy volunteers was set up. The changes of tongue fur, grade of major syndromes in different groups were observed and scored before and after treatment to evaluate the therapeutic effectiveness, and the apoptotic index (AI) was estimated using TUNEL technique.

RESULTSAI in the two patient groups before treatment was obviously lower than that in the normal group (P < 0.01 or P < 0.05); after treatment, AI in the treatment group increased significantly (P < 0.01), with no difference from that in the normal group (P > 0.05), while in the control group, it only showed a slight trend of increasing. Similar outcome of tongue fur grades was seen in the two groups, it was improved significantly (P < 0.01) in the treatment group but insignificantly in the control group (P > 0.05). After treatment, syndrome scores were both lower in the two groups (P < 0.01), but the decrement in the treatment group was more significant than that in the control group (P < 0.01). Comparison between groups showed that the total effective rate in the treatment group was significantly superior to that in the control group (90% vs 65%, P < 0.01).

CONCLUSIONHXD has good clinical efficacy in treating PWDHS, and has good effect in alleviating the greasy yellow tongue fur in patients with PWDHS by accelerating the tongue epithelial cell apoptosis.

Adult ; Apoptosis ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Epithelial Cells ; drug effects ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; Tongue ; cytology

Objective To investigate the status of non-immunization program vaccination among children in Shanghai. Methods Three districts were randomly selected for investigation in Shanghai.In the survey area, probability proportional to size sampling method was used to investigate the vaccination situation of non-immunization program and willingness to accept vaccination service in children aged 0-6 years old. Results A total of 416 children aged 0-6 years and their parents were investigated, 93.27%(388) of children received 1 dose or more of non-immunization program vaccines and 36.54% of children received 5 or more non-immunization program vaccines.The coverage of haemophilus influenzae type b conjugate vaccine, 13-valent pneumococcal conjugate vaccine, enterovirus 71 inactivated vaccine, oral rotavirus vaccine and influenza vaccine were 25.00%, 20.91%, 57.45%, 53.37% and 14.42%, respectively.64.95% of parents decided to vaccinate their children with non-immunization program vaccines because of the recommendation of vaccination staff.And 85.58% of parents requested vaccination staff to inform them or make appointments with non-immunization program vaccination.84.62% of parents could accept the charge for vaccination service. Conclusion In Shanghai, the proportion of children receiving multiple non-immunization program vaccination is relatively low and their parents′ demand for vaccination notification services is high.Vaccination staff should be encouraged to actively provide non-immunization program vaccination services, meeting the diverse needs of the public.

Objective To investigate the association between platelet glycoprotein Ibα (GPIbα) gene HPA-2a/b polymorphisms and the risk of Kawasaki disease (KD) and that complicated with coronary artery lesion (CAL).Methods A total of 30 patients with KD and 60 healthy controls were genotyped by polymerase chain reaction-restriction fragment length polymorphism and agarose gel electrophoresis for the HPA-2a/b polymorphism in GPIbα gene.Results For HPA-2a/b polymorphism in GPIbα gene,there was only genotype TC and CC of HPA-2a/b polymorphism in GPIbα gene in children with KD and healthy controls,and genotype TF was not found in both groups.There were no significant differences between KD patients and the controls in genotype frequencies of CC,TC and TT and allele frequencies of C and T (x2 =0.052,0.048,all P ＞ 0.05) ; also there was no significant difference between KD patients with CAL and that without CAL in genotype and allele frequencies (x2 =2.672,2.481,all P ＞ 0.05).Conclusion No association is found between HPA-2a/b polymorphism in GPIbα gene and the risk of KD or its complication of CAL in this study.

AIM: Accommodation is one of the most important functions of human eye, while its mechanism is still under discussion. This paper aimed to study accommodation mechanism with numerical simulation.METHODS: A simulation model was constructed to study the mechanism of accommodation based on the experimental data derived from published resources. The displacement and pressure are applied on the model to study the deformation of lens during accommodating.RESULTS: The simulation showed that, as the eye was accommodating, the thickness of the lens increased linearly,and the lens diameter decreased linearly. The optical power of the lens increased as the accommodation increased. This result was accord with the public facts in accommodation.Furthermore, the pressure was found to have a great influence on the shape of the lens and the optical power. The lens became thinner and flatter as the pressure increased and the pressure caused a remarkable increase of lens' optical power.CONCLUSION: The outcome of this paper is consistent with the Helmholtz's hypothesis on accommodation to some extent. The analytical model presented in this paper can be used in the theoretical study of the accommodation mechanism of the human lens.

Objective To investigate the neutralized antibody level of poliomyelitis among healthy children before and after implementation of the new immunization strategy in Shanghai. Methods The poliomyelitis levels of healthy children were detected by neutralization test of the micro cells. Results The neutralizing antibody positive rates were 100% for polioⅠand polioⅢ before and after implementation of the new immunization strategy.GMTs (geometric mean titers) for polioⅠwere 1:1 047.46 before it, and 1:254.70 after it; those for polio Ⅲ were 1:513.52 before it and 1:185.49 after it. Conclusion The neutralized antibody levels of the poliomyelitis among healthy infants maintain a high level before and after implementing the new immunization strategy in Shanghai.

OBJECTIVETo observe the therapeutic effect of scalp electroacupuncture on Parkinson disease (PD) of grade 1.5-3.0 on Hoehn-Yahr scale.

METHODSThirty patients with Parkinson disease were randomized equally into the treatment group and control group. Patients in the treatment group were treated by scalp eletroacupuncture at the contralateral points of MS6, MS4, MS8, MS9 and MS14 in cases of unilateral lesions or at the bilateral points for bilateral lesions, with also medication with Madopar. The patients in the control group were given Madopar only. The scores of Webster scale and the motor function of United Parkinson's Disease Rating Scale (UPDRS) were used to for assessment before and after the therapeutic course (6 weeks).

RESULTSTremor, rigidity and bradykinesia were obviously improved in both the groups (P<0.05). The difference in the score of Webster scale was not significant between the two groups (P>0.05), but the treatment group showed greater improvement in motor functions than the control group (P<0.05).

CONCLUSIONScalp electroacupuncture is effective and safe for therapy of Parkinson disease.

Aged ; Electroacupuncture ; methods ; Female ; Humans ; Male ; Middle Aged ; Parkinson Disease ; therapy ; Scalp

Objective To analyze the radiation dose to contra-lateral breasts and estimate the incidence risk of contra-lateral breast cancer for women undergone unilateral breast cancer radiotherapy.Methods The radiation doses of contra-lateral breasts for 49 patients were counted and analyzed in a hospital,and the risk of contra-lateral breast cancer in different age groups that induced by radiotherapy was estimated based on BEIR Ⅶ model combined with the Chinese lifetime table.Results The prescribed doses for the patients were all 50 Gy.The mean dose to contra-lateral breasts ranged from 0.14 Gy to 3.59 Gy,with an average of (1.21 ±0.89) Gy,and the maximum point dose varied from 0.98 Gy to 45.27 Gy,with the average of (17.42 ±13.20) Gy.Both the maximum point dose and the mean dose obviously varied among the patients,and their correlation was significant (R =0.527,P =0.000).Furthermore,no significant differences of the mean dose was found among the ages (P ＞ 0.05).The lifetime attribute risks of contra-lateral breast cancer were estimated to be 2 449,1 857,994,446,173 and 55 for per 100 thousand women corresponding to the ages of 35,40,50,60,70 and 80,respectively.Conclusions In the radiotherapy for unilateral breast cancer,the dose delivered to the contra-lateral breast is about 1 Gy order of magnitude,the risk of contra-lateral breast cancer cannot be ignored for young women.Therefore,the irradiation dose of contra-lateral breasts should be controlled as less as possible in planning the treatment.