OBJECTIVE: To evaluate the feasibility and accuracy of cone-beam CT (CBCT) images for radiotherapy dose calculation in pelvic tumors. METHODS: An improved volumetric density coverage method was used to establish CT value-relative electron density (RED) curves for CBCT images. The planning CT plans were transferred to the CBCT images, and the constructed density curves were applied to calculate doses for CBCT plans while maintaining the optimization parameters unchanged. Dose calculation deviations between the two plans were analyzed. RESULTS: The mean differences in dosimetric parameters for the target volume and organs at risk (OAR) between the two plans were less than 1% and 1.5%, respectively. The target conformity index (CI), homogeneity index (HI), and gamma passing rates were highly consistent, with no statistically significant differences. CONCLUSION CBCT images corrected by this method can be used for dose calculation in pelvic tumor radiotherapy planning.
Cone-Beam Computed Tomography/methods* ; Humans ; Radiotherapy Planning, Computer-Assisted/methods* ; Radiotherapy Dosage ; Pelvic Neoplasms/diagnostic imaging*

Based on the management by objectives and developmental performance appraisal,Shanghai Tenth People's Hospital explored the performance appraisal scheme for attending,including disease-specific complexity,disease-specific difficulty,clinical risk-taking and comprehensive quality.Assessment and feedback work was imple-mented by the medical management department,which format a set of independent budget of the physician perfor-mance assessment system.It introduced incentive measures to encourage attending to treat difficult and critical cases,provided high quality medical services,and eventually enhance hospital management effectiveness to attending.

Based on the management by objectives and developmental performance appraisal,Shanghai Tenth People's Hospital explored the performance appraisal scheme for attending,including disease-specific complexity,disease-specific difficulty,clinical risk-taking and comprehensive quality.Assessment and feedback work was imple-mented by the medical management department,which format a set of independent budget of the physician perfor-mance assessment system.It introduced incentive measures to encourage attending to treat difficult and critical cases,provided high quality medical services,and eventually enhance hospital management effectiveness to attending.

Based on the management by objectives and developmental performance appraisal,Shanghai Tenth People's Hospital explored the performance appraisal scheme for attending,including disease-specific complexity,disease-specific difficulty,clinical risk-taking and comprehensive quality.Assessment and feedback work was imple-mented by the medical management department,which format a set of independent budget of the physician perfor-mance assessment system.It introduced incentive measures to encourage attending to treat difficult and critical cases,provided high quality medical services,and eventually enhance hospital management effectiveness to attending.

Based on the management by objectives and developmental performance appraisal,Shanghai Tenth People's Hospital explored the performance appraisal scheme for attending,including disease-specific complexity,disease-specific difficulty,clinical risk-taking and comprehensive quality.Assessment and feedback work was imple-mented by the medical management department,which format a set of independent budget of the physician perfor-mance assessment system.It introduced incentive measures to encourage attending to treat difficult and critical cases,provided high quality medical services,and eventually enhance hospital management effectiveness to attending.

Based on the management by objectives and developmental performance appraisal,Shanghai Tenth People's Hospital explored the performance appraisal scheme for attending,including disease-specific complexity,disease-specific difficulty,clinical risk-taking and comprehensive quality.Assessment and feedback work was imple-mented by the medical management department,which format a set of independent budget of the physician perfor-mance assessment system.It introduced incentive measures to encourage attending to treat difficult and critical cases,provided high quality medical services,and eventually enhance hospital management effectiveness to attending.

Based on the management by objectives and developmental performance appraisal,Shanghai Tenth People's Hospital explored the performance appraisal scheme for attending,including disease-specific complexity,disease-specific difficulty,clinical risk-taking and comprehensive quality.Assessment and feedback work was imple-mented by the medical management department,which format a set of independent budget of the physician perfor-mance assessment system.It introduced incentive measures to encourage attending to treat difficult and critical cases,provided high quality medical services,and eventually enhance hospital management effectiveness to attending.

Based on the management by objectives and developmental performance appraisal,Shanghai Tenth People's Hospital explored the performance appraisal scheme for attending,including disease-specific complexity,disease-specific difficulty,clinical risk-taking and comprehensive quality.Assessment and feedback work was imple-mented by the medical management department,which format a set of independent budget of the physician perfor-mance assessment system.It introduced incentive measures to encourage attending to treat difficult and critical cases,provided high quality medical services,and eventually enhance hospital management effectiveness to attending.

Based on the management by objectives and developmental performance appraisal,Shanghai Tenth People's Hospital explored the performance appraisal scheme for attending,including disease-specific complexity,disease-specific difficulty,clinical risk-taking and comprehensive quality.Assessment and feedback work was imple-mented by the medical management department,which format a set of independent budget of the physician perfor-mance assessment system.It introduced incentive measures to encourage attending to treat difficult and critical cases,provided high quality medical services,and eventually enhance hospital management effectiveness to attending.

Objective:To investigate the safety and effectiveness of robot-assisted total knee arthroplasty (TKA).Methods:From August 2021 to March 2022, the data of 69 patients who received robot-assisted TKA for inflammatory disease of knee in 6 hospitals were collected, including 24 males and 45 females, aged 52±6 years (range, 46-72 years), including 53 cases of knee osteoarthritis,10 cases of rheumatoid arthritis, and 6 cases of traumatic arthritis. Imaging data examination of patients was completed according to the multicenter specification. Preoperatively, the patient's CT data were extracted before surgery and a personalized prosthesis positioning plan was designed by the robotic system to determine the prosthesis size, lower limb force lines, and femoral and tibial osteotomy volumes; intraoperatively, the osteotomy template was robotically controlled to complete the osteotomy according to the prosthesis positioning plan, and the intraoperative osteotomy volumes were measured to verify the accuracy of the robot-assisted TKA osteotomy with the preoperative planning. Postoperatively, the lateral angle of the distal femur, the medial angle of the proximal tibia and the hip-knee-ankle angle were measured in the coronal plane according to radiographs; the postoperative outcome was evaluated 3 months after operation, using the American Knee Society score (KSS), including the KSS knee score and functional score.Results:The operative time was 97.3±2.3 min (range, 80-110 min) and the amount of bleeding was 320.0±6.2 ml (range, 300-350 ml) in 69 patients. Three months after operation, the mean range of motion of knee joint was increased from 82.2°±1.1° before surgery to 119.7°±0.8° after surgery ( t=27.65, P<0.001), and the line of force of lower limb was improved from 160.9°±0.5° before surgery to 178.0°±0.2° after surgery ( t=32.03, P<0.001). KSS-knee score increased from 54.8±0.7 points before operation to 85.0±0.5 points after operation, and KSS-functional score increased from 56.5±0.7 points before operation to 85.9±0.4 points after operation, the difference was statistically significant ( t=35.45, 36.58, P<0.001). The proportion of patients with intraoperative femoral and tibial osteotomies within 2 mm osteotomy error compared with preoperative planning was 97% for the lateral tibial plateau, 100% for the medial tibial plateau, 100% for the lateral distal femur, 99% for the medial distal femur, 93% for the lateral posterior femoral condyle, and 100% for the medial posterior femoral condyle; The proportion of patients with postoperative anteroposterior X-ray measurement angle error within 3° was: 100.0% for the distal lateral femoral angle, 100.0% for the proximal medial tibial angle, and 100% for the hip-knee-ankle angle. No complications occurred in all patients except for one case in which fat liquefaction occurred in the postoperative wound. Conclusion:Robot-assisted TKA is a safe and effective surgical method for the treatment of inflammatory disease of knee with accurate prosthesis installation and good postoperative recovery of lower limb alignment.