The similarity and difference between stationary and mobile electronic linear accelerators in intra-operative radiation therapy are introduced. The contents and methods of quality assurance for stationary and mobile electronic linear accelerators and the key points to deliver intra-operative radiation therapy are described.

Objective:To analyze and compare the results and precision of three different methods to measure the surface dose of Intra-operative radiotherapy,and conclude some experience of clinical application in Intra- operative radiotherapy.Methods:The study compared the results of measurement surface dose in phantom through three ways:cylindrical ionization chamber with 3D water scanner,plane-parallel ionization chamber,and MOSFET detector.Results:the measurement results of plane-parallel-chamber and MOSFET detector have a better consistency,and the maximum deviation is -1.13%.The method with cylindrical ionization chamber and 3D water scanner has larger deviation compare to the other two methods,the deviation range from-5.55%to 4.55%.Conclusion:The methods of plane-parallel chamber and MOSFET detector to measure the surface dose of Intra-operative radiotherapy can obtain accurate results.

Objective To assess the efficacy of stone fragmentation and clearance of this new intracorporeal ultrasound lithotripter (CQS-01) compared with currently available ultrasound units (EMS-Ⅲ/Ⅳ).Methods Twenty phantom stones composed of dental gypsum were randomly divided into four groups,and CQS-01 ultrasound lithotripter (70％ power and 70％ duty factor),EMS-Ⅲ ultrasound lithotripter (70％ power and 70％ duty factor),EMS-Ⅳ ultrasound lithotripter (type A,70％ power and 70％ duty factor) and EMS-Ⅳ ultrasound lithotripter (type B,70％ power and 100％ duty factor) were used to fragment and removepbantom stones.The mean stone breakdown time and fragment removal time and stone fragmental sizes for the standard ultrasound devices were compared to determine the completeness and efficiency of stone fragmentation and removal.Results The average time for stone breakdown was 7.4 ± 1.9 s,9.4 ± 1.6 s,82.2 ± 12.6 s and 51.4 ± 18.7 s,respectively.There was no significant difference between CQS-01 and EMS-Ⅲ (P ＞ 0.05),but there was significant difference between CQS-01 and EMS-Ⅳ (A or B) (P ＜ 0.001).The average time for stone clearance using the ultrasound devices was 387.8 ± 68.0 s,41 1.6 ± 57.6 s,568.0 ± 119.1 s and 383.6 ± 75.6 s,respectively.In addition,the average size of the largest fragments removed was the same among the groups (＜ 3 mm).Conclusion The ultrasound capabilities in a newly developed lithotriter (CQS-01) exhibited the same ability to fragment and clear phantom stones compared with standard ultrasound devices.

Objective To explore the distribution characteristics of ankle-brachial index ( ABI) examination for peripheral arterial dis-ease in diabetic patients, and to provide basis for clinical diagnosis. Methods Randomly selected 110 cases of patients who were admitted into our hospital from February 2014 to January 2015, and divided them into the observation group (34 cases with diabetic lower extremity peripheral vascular lesions) and the control group (76 cases without diabetic lower extremity peripheral vascular lesions). Measured the ABI of the two groups, and analyzed the value of ABI data range for the diagnosis of diabetic lower extremity peripheral vascular lesions. Mean-while, analyzed the risk factors of peripheral arterial disease in diabetic patients according to ABI. Results The sensitivity of ABI for diag-nosis of diabetic lower extremity peripheral vascular lesions was 91. 18%, and the coincidence rate was 95. 36%, the specificity was 98. 68%, the misdiagnosis rate was 8. 82%, and the omission diagnostic rate was 8. 82%. ABI of the observation group was obviously lower than that of the control group, and the difference was statistically significant (P<0. 05). Conclusion ABI examination could be basis of clinical diagnosis and important standard of disease assessment for peripheral arterial disease in diabetic patients. It is suggested to strengthen the control of blood glucose, blood pressure and weight of patients with diabetes in order to reduce the risk of morbidity.

Objective To investigate the characteristics of the objective sleep disturbances in Parkinson' s disease (PD) and the factors related to it.Methods One hundred and one PD patients and 90 age- and sex- matched controls underwent a video-polysomnography.The sleep parameters and its related factors in two groups were analyzed.Results Sleep latency was not statistically different in comparing two groups.PD patients had a higher percentage of non-rapid eye movement( non-REM ) sleep stage 1 and a lower percentage of non-REM sleep stage 2 compared with controls ( 27.9 ± 1 7.8 vs 21.2 ± 11.7,t =3.034,P =0.003 ;47.8 ± 17.4 vs 54.7 + 12.9,t =- 3.043,P =0.003 ).Reduced sleep efficiency,decreased the proportion of slow wave sleep and REM sleep,increased awake time and longer REM sleep latency occurred in PD patients.There were no significant differences of these above parameters.Some sleep parameters in PD patients were correlated with advancing age,the severity of PD,and the degree of depression.The index of periodic leg movements in sleep (PLMSI) of 41 PD patients (40.6％ ) was more than 15.These PD patients didn' t complain corresponding symptoms about their legs.The PLMSI in PD patients were significantly higher than the controls.PLMSI increased with aging in the PD group( r =0.261,P ＜0.01 ).PD patients didn' t suffer significantly lower apnea- hypopnea index and oxygen desaturation index.The lowest SPO2 ( L-SPO2 ) increased in the PD group.REM sleep without atonia occurred in 83 patients (82.2％) with PD.Thirty-eight patients (37.6％) were diagnosed with REM sleep behavior disorder (RBD).The incidences of REM without atonia and RBD in the PD group were significantly higher than in the control s(0 and 8 patients (8.9％),x2 =42.271,102.480; both P ＜ 0.01 ).Conclusions The sleep parameters in PD patients are changed.For PD patients,there is no difficulty in falling asleep.The PD patients also have sleep structure disorder and difficulty in maintaining sleep.The sleep parameters are correlated with advancing age,the severity of PD,and the degree of depression in PD.PLMS don' t lead to sleep disturbances in PD patients.The blood oxygen saturation don' t decrease severely when PD patients suffer apnea or hypopnea.RBD occur more frequently in PD patients.

Objective To investigate the expression of inregrin?_3 and integrin?_1 in breast cancer and its bio- logical significance.Methods Immunohistochemical assay was used to determine the expression of integrin?_3 and integrin?_1 in the breast cancer(32 cases).Results In normal breast tissue,the positive expression rates of integrin?_3 and integrin?_1 were 0 % and 25 %.In the breast cancer tissue,the positive expression rates of integrin?_3 and inte- grin?_1 were 36 % and 81%.Conclusion The integrin?_3 and integrin?_1 are close associated with the biological sig- nificance of breast cancer.To examine its expression is useful to evaluate the aggressive degree,metastatic potential and prognosis in patients with breast cancer.

AIM:To study the dynamic alteration of low-density lipoprotein receptor ( LDLr) expression after exposure to hepatocyte growth factor (HGF) in human Tenon's capsule fibroblasts (HTFs).METHODS: HTFs were stimulated with HGF at different concentrations (0, 10, 20, 40, 80 and 160μg/L) for 12, 24, and 48 h.The viability of HTFs was analyzed by MTT assay .The expression of LDLr at mRNA and protein levels were analyzed by real-time PCR and Western blot .RESULTS:The expression of LDLr at mRNA and protein levels was positively correlated with the viability of HTFs.HGF promoted the viability of HTFs in a time-and concentration-dependent manner .At the same time , HGF pro-moted the expression of LDLr in the same manner .CONCLUSION:Exposure of HTFs to HGF induces LDLr expression at high level , suggesting that over-expression of LDLr on the HTFs may be a target receptor for controlled drug delivery , par-ticularly in anti-scarring therapy after glaucoma filtration surgery .

Objective To explore the relationship among depression,anxiety and social support in elderly patients in community outpatient clinic. Methods A total of 551 elderly outpatients from two com-munity health service centers of Hongkou District in Shanghai were evaluated with patient health question-naire-9 (PHQ-9),generalized anxiety disorder-7 (GAD-7),perceived social support scale( PSSS) for de-pression,anxiety,physical health and social support. Results The prevalence rates of depression and anxiety were 26. 1% and 17. 2%,respectively. The scores of PHQ-9 and GAD-7 were 2. 0(4. 0) and 1. 0(2. 0). There were statistically significant differences in the scores of family support,friend support,other support and social support among the elderly patients with different degrees of depression or anxiety (P<0. 01). Fam-ily support(B=-0. 196) and friend support(B=-0. 171) were protective factors of depression in elderly pa-tients in community outpatient clinic. Age,family support and friend support were protective factors of anxiety in elderly patients,while gender and fluctuation of physical diseases were protective factors of anxiety(P<0. 05). Con-clusions The depression and anxiety is intimately related to social support in elderly outpatients. Appropriate measures should be taken to optimize social support,mitigate bad mood negative improve their quality of life.

OBJECTIVETo investigate the impact of metal implants with different materials on radiation dose distribution based on film measurement method.

METHODSTitanium plate, titanium intramedullary pin and stainless steel plate were set into phantom and irradiated separately by 6 MV and 15 MV X ray from linear accelerator. Dose distributions derived from different materials metal implants were measured and analyzed by film dosimeter.

RESULTSFor 6 MV X ray, the maximum interface dose increments of titanium plate, titanium intramedullary pin and stainless steel plate were 12.3%, 15.4% and 20.3%. As the radiation energy was increased from 6 MV to 15MV, the maximum interface dose increment of the titanium plate rose from 12.3% to 15.1%, the maximum interface dose increment of the steel plate rose from 20.3% to 30.8%.

CONCLUSIONSMetal implants with different materials have obvious impact on radiation dose distribution. With the increase of the metal atomic number and energy of radiation, the degree of elevated dose also increases. These results suggest that correction of dose distribution is required for radiotherapy of patients with metal implants.

To purify recombinant human nucleoside diphosphate kinase A (rhNDPK-A) efficiently in pilot scale, cells of rhNDPK-A producing E. coli were homogenized by high pressure under 4 degrees C, 950 Pa. The insoluble debris was removed by microfiltration and the soluble portion was concentrated by ultrafiltration. The resulted crude sample was loaded on DEAE-sepharose Fast Flow. The target fraction was collected and then load on Cibacron Blue 3GA Sepharose CL-4B. Eluted with buffer containing ATP from the AC column, rhNDPK-A was polished with ultrafiltration. The results showed that after homogenized 2 rounds, 1500g cells of E. coli brought crude sample containing 47.6g NDPK-A. Treated with microfiltration and ultrafiltration, 27.3g of NDPK-A were recovered from this bacteria homogenate. After 2-step purification with column chromatography and then polished with ultrafiltration, 17.2 g rhNDPK-A were collected with purity of 96.3%. The recovery of the whole purification process was 36.2%, and the productivity of rhNDPK-A was 1.15 g per 100 g wet cells. Comparing the recovery of each purification step, it was found that the recovery of polish is higher than that of affinity chromatography, which is higher than that of ion exchange chromatography. The limit step was the process of sample pretreatment among the 4 purification steps. Combine with the fermentation results reported before, it was deduced that the productivity of rhNDPK-A was 510 mg/L. In conclusion, an easily controlled purification condition with high yield provides material for the translation researches of NDPK; In addition, it was suggested the crucial step determine the recovery of non-secretive recombinant proteins might be the process of sample pretreatment, not be the process of column chromatography.
Chromatography, Affinity ; Chromatography, Ion Exchange ; Electrophoresis, Polyacrylamide Gel ; Escherichia coli ; genetics ; Humans ; NM23 Nucleoside Diphosphate Kinases ; genetics ; metabolism ; Pilot Projects ; Recombinant Proteins ; isolation & purification ; metabolism ; Ultrafiltration