Objective:To explore the dosimetric characteristics of proton and photon radiotherapy in the treatment of breast cancer.Methods:Four female breast cancer patients who needed radiotherapy at Shandong Cancer Hospital and Institute from January 2024 to May 2024 were selected as the research subjects. The target area ranges of 4 patients were left-sided breast cancer with lymph node involvement, left-sided breast cancer with lymph node involvement and internal mammary node, right-sided breast cancer with lymph node involvement and internal mammary node and synchronous bilateral breast cancer. Intensity modulated proton therapy (IMPT) and intensity modulated radiation therapy (IMRT) plans were designed respectively based on the prescribed dose in the target area and the limits of organs at risk (tomotherapy plan for bilateral breasts). The conformity index (CI), homogeneity index (HI), gradient index (GI) and organs at risk doses were evaluated. The dosimetric characteristics of IMPT and photon radiotherapy were compared.Results:Both IMPT and photon radiotherapy plans of the 4 breast cancer cases met the clinical dose requirements. The HI value of IMPT plans (0.10-0.14) was comparable to that of photon radiotherapy plans (0.10-0.12), and the average CI of the photon radiotherapy plans was 0.10 higher than that of the IMPT plans, and the average GI was 0.55 lower than that of the IMPT plans. The D mean of ipsilateral lung and heart of IMPT was lower, especially in the low-dose area (V 0-3), which was significantly lower than the photon radiotherapy plans, D mean of ipsilateral lung was reduced by 12.2%, 6.1%, 16.1% and 34.8%, respectively, D mean of heart was reduced by 47.2%, 57.0%, 72.4% and 83.0%, respectively. The ipsilateral lung V 20 of IMPT was not lower than photon radiotherapy plans (unilateral breast: IMPT was 30.0%-34.0%, IMRT was 29.0%-35.9%) . Conclusions:IMPT significantly reduces the D mean to the ipsilateral lung and heart while ensuring dose coverage of the target in breast cancer, preventing more volume of surrounding normal tissues from being irradiated. However, IMPT does not show much more advantage than photon radiotherapy plans in the ipsilateral lung V 20.

Abstract OBJECTIVE To establish an efficient and simple HPLC-MS/MS method for determination of flucloxacillin in newborn plasma, and to investigate the interaction between ambroxol and flucloxacillin in newborns. METHODS The samples were analyzed by API4000 HPLC-MS/MS. Ultimate XB-C18 column(2.1 mm×100 mm, 5 μm) were carried out. The mobile phase was composed of water-0.1% formic acid(A) and acetonitrile-0.1% formic acid(B). The quantitative analysis of the ion transitions were monitored at m/z 452.6→284.2 for flucloxacillin and m/z 821.4→397.3 for rifampicin(internal standard). RESULTS The linear range of flucloxacillin under this analysis method was 0.20-80 ng·mL-1, and the lower limit of quantification was 0.20 ng·mL-1; The intra-day and inter-day precision of flucloxacillin were both less than 8.23%; The extraction recovery was in the range of 85.3%-89.2%, and the matrix effect was between 89.3%-92.3%; The stability of plasma samples was good under conditions of 12 h at room temperature, 4 h at room temperature after treatment, repeated freeze-thaw for 3 times, and -20 ℃ freezing for 30 d. The results of clinical samples indicated that the combination of ambroxol could significantly increase the blood concentration of flucloxacillin. CONCLUSION The established HPLC-MS/MS method is accurate, sensitive and can be used for the determination of flucloxacillin concentration in neonatal plasma. The results of clinical samples indicate that ambroxol can significantly increase the blood concentration of flucloxacillin. There are drug interactions between ambroxol and flucloxacillin.

ObjectiveTo assess the effects of testicular sperm and epididymal sperm on the outcomes of ICSI for patients with obstructive azoospermia.

METHODSWe searched PubMed, MEDLINE, EMBASE, Cochrane, CNKI, VIP, CBM, and Wanfang Database up to December 2015 for published literature relevant to ICSI with testicular or epididymal sperm for obstructive azoospermia patients. According to the inclusion and exclusion criteria, two reviewers independently conducted literature screening, data extraction and quality assessment of the included trials, followed by meta-analysis with the RevMan 5.3 software.

RESULTSA total of 14 studies were identified, involving 1 278 patients and 1 553 ICSI cycles. ICSI with epididymal sperm exhibited a significantly higher fertilization rate than that with testicular sperm (RR = 1.08, 95% CI 1.05－1.11, P<0.01). No statistically significant differences were observed between the epididymal and testicular sperm groups in the rates of cleavage (RR = 1.04, 95% CI 0.99－1.10, P = 0.13), good-quality embryo (RR = 1.01, 95% CI 0.93－1.09,P = 0.85), implantation (RR = 1.14, 95% CI 0.75－1.73, P = 0.55), clinical pregnancy (RR = 1.14, 95% CI 0.98－1.31, P = 0.08), and miscarriage (RR = 0.86, 95% CI 0.53－1.39,P = 0.54).

CONCLUSIONSICSI with epididymal sperm yields a markedly higher fertilization rate than that with testicular sperm, but has no statistically significant differences from the latter in the rates of cleavage, good-quality embryo, implantation, clinical pregnancy, and miscarriage in the treatment of obstructive azoospermia.

Objective:To investigate the long-term risk of esophageal cancer from fresh fruit consumption. Methods:In 1985, a total of 29,479 participants aged between 40 and 69 years old were recruited for this study. Demographic characteristics, lifestyle, history of diseases, and food intake frequency were surveyed at the baseline and were then followed up. Through December 31, 2015, a median of 31.79 years of observation was obtained. The primary endpoint was death from esophageal cancer. The hazard ratio and 95%confi-dence intervals for fresh fruit consumption were calculated using a Cox proportional hazard model. Results:Overall, 31.09%of partici-pants reported consuming fresh fruit more than once every week. Compared with participants who never or rarely consumed fresh fruit, those who consumed fresh fruit more than once a week had a lower long-term risk of esophageal cancer. Death rate decreased to 7%among those who ate fresh fruit more than once a week, especially among males (11%) and those with positive smoking history (13%). Conclusion:Fresh fruit consumption is associated with a lower risk of death from esophageal cancer, but the etiological mecha-nism needs to be investigated further.

Objective To explore surgical procedure of combined anterior-lateral and lateral approach for the treatment of bone tumors of femoral neck. Methods Forty patients with bone tumors of femoral neck treated in Tianjin Hospital were included from July 2005 to August 2009. Of the patients, 12 who were treated with curettage and bone graft through combined anterior-lateral and lateral incision were analyzed in this study. There were 7 males and 5 females with an average age of 34 years ranging from 17 to 68 years. 4 patients were diagnosed as chondroblastoma, 2 giant cell tumor, 3 fibrous dysplasia, and 3 single bone cysts. 7 patients suffered from pathologic fractures, and 5 had presented thin cortical bone because of tumor involvement. There were 1 tumor located in H1 zone, 4 in H2 zone and 7 in H1,2 zone according to ISOLS femoral neck classification. All patients were treated by curettage and bone graft via anterior-lateral approach, 10 cases underwent internal fixation with anatomical plate, and 2 cases with canulated screws with lateral approach. Results The follow-up time ranged from 10 to 68 months with an average of 35 months.Pain disappeared in all patients, and there were not recurrence of tumor, pathologic fractures and avascular necrosis. One case had complained of lateral femoral skin numbness which may be caused by injures of femoral lateral nerves. One case had difficulties in the valgus of hip joint. The mean MSTS score was 29.2 points ranging from 27 to 30 points. Conclusion Anterior approaches of "SP" incision is helpful to thorough curettage which decrease the risk of recurrence due to good visualization and intemal fixation is easy to perform via lateral approaches. The result suggested that combined anterior-lateral "SP" and lateral incision is liable option in treatment of bone tumors of femoral neck.

Objective To estimate the appropriate margins for the clinical target volume (CTV) with or without online correction using cone-beam CT(CBCT) during the processs of radiation for non-small cell lung cancer(NSCLC) patients. Methods Eight patients with NSCLC treated with three-dimensional conformal ra-diotherapy(3D-CRT) were investigated, kV CBCT scans were performed before and immediately after radio-therapy. Then analysis of these images was performed using automatic and manual registration of the CBCT and planning computed tomography images. The patient positioning and organ motion were corrected by moving the couch in the left- right (X), cranio- caudal (Y), and anterior- posterior (Z) directions accordingly, and CBCTonline-guided correction data were recorded. The clinical study performed 2-3 times per week. CBCT data ac-quired before treatment delivery were used to evaluate the positioning error and organ motion, and that acquired after treatment were used to assess intrafraction tumor displacement and organ motion. These data were used in a standard formula to calculate CTV-to-PTV(planning target volume) margin of online-guided correction and non-online-guided correction. Results Total of 143 sets of CBCT images were analyzed. On the condition of non- correction, the margins required to account for total errors were 8 mm, 9 nun, 11 mm in X, Y and Z direc-tions respectively. When the tumor was corrected every fraction, margins required to account for intrafraction errors were 2 mm in each directions. Conclusion There are some extent of errors from positioning and organ motion in 3D-CRT for NSCLC. Online correction approach based on CBCT images analysis can be used to re-duce the impact obviously and to estimate the appropriate margins for the CTV.

OBJECTIVETo evaluate the relationship between infection of Chlamydia Trachomatis(Ct) and apoptosis of spermatogenic cells.

METHODSApoptotic spermatogenic cells were examined by Wright-Giemsa staining and the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate(dUTP)-biotin nick-end labeling(TUNEL) technique.

RESULTSApoptosis rate of Ct infective group was significantly higher than that of normal group(P < 0.01).

CONCLUSIONSCt infection may cause the apoptosis of spermatogenic cells, which affords an objective evidence for illustrating the mechanism of Ct-infection-induced male infertility.

Adult ; Apoptosis ; Chlamydia Infections ; complications ; pathology ; Chlamydia trachomatis ; Humans ; In Situ Nick-End Labeling ; Infertility, Male ; etiology ; Male ; Spermatocytes ; pathology ; Staining and Labeling