Objective To explore the feasibility of quartz glass for radiotherapy dosimetry through the experimental study of the thermoluminescence characteristics of synthetic quartz glass. Methods The thermoluminescence glow curves of quartz glass under different annealing conditions were analyzed, the thermoluminescence characteristics of quartz glass were studied, and the measurement parameters were optimized. Using the Co-60 reference radiation field in the National Secondary Standard Dosimetry Laboratory, the quartz glass samples under different annealing conditions were irradiated following the dose levels of radiotherapy, i.e., 0.5, 1.0, 2.0, 4.0, 6.0, 8.0, and 10.0 Gy, respectively. According to the relationship between the absorbed dose of quartz glass and the relative thermoluminescence signal intensity, the linearity and dispersion of the dose response of quartz glass were obtained, and the feasibility of quartz glass for radiotherapy dosimetry was analyzed. Results The linear correlation coefficient of dose response of quartz glass under annealing condition of 430℃ for 10 min was 0.9984, and the dose response dispersion was 0.97% at the absorbed dose of 2 Gy. The linear correlation coefficient of dose response of quartz glass under annealing condition of 600℃ for 1 h was 0.9911, and the dose response dispersion was 1.4% at the absorbed dose of 2 Gy. Conclusion Preliminary results suggest that quartz glass with annealing condition of 430℃ for 10 min has the potential to be used for radiotherapy dosimetry.

Objective:To study the effects of arsenic exposure on necroptosis pathway and inflammatory response of mouse myocardial cells.Methods:Sixty male C57BL/6J mice were randomly divided into control group (group C) and low, medium, and high dose arsenic exposure groups (groups L, M, H) based on body weight using a random number table method. Each group had 15 mice, and they drank 0.00, 0.15, 1.50, and 15.00 mg/L arsenic trioxide (As 2O 3) solution prepared with deionized water. The exposure period was 12 weeks. Hematoxylin-eosin (HE) staining and Masson trichrome staining of paraffin-embedded heart tissues were used to observe the histopathology changes of the heart. Transmission electron microscopy (TEM) was used to evaluate the ultrastructural changes of myocardial cells. The quantitative real-time PCR (qRT-PCR) was used to detect the mRNA expression of inflammatory genes [tumor necrosis factor (TNF)-α and interleukin(IL)-6] and the genes involved in necroptosis pathway [receptor-interacting protein (RIP) 1, RIP3 and mixed-lineage kinase domain-like protein (MLKL)]. Protein expressions of RIP1 and RIP3 in the heart were assessed by western blotting. Results:Histopathological examination results showed there were myocardial necrosis, inflammatory cells infiltration and fibroblasts hyperplasia and other changes in groups M and H. TEM analysis revealed marked ultrastructural changes in groups M and H, including fractured myofibril, fractured Z lines of sarcomere, and swollen mitochondria with fractured cristae. Compared with group C (1.00 ± 0.00), the mRNA expression of RIP1 in group H was significantly up-regulated (1.41 ± 0.06, P < 0.05); the mRNA expressions of RIP3 (1.29 ± 0.14, 1.56 ± 0.08), MLKL (1.23 ± 0.05, 1.36 ± 0.07), TNF-α (2.20 ± 0.10, 2.23 ± 0.18) and IL-6 (1.87 ± 0.16, 1.63 ± 0.15) were significantly up-regulated in groups M and H ( P < 0.05). The protein expressions of RIP1 (0.43 ± 0.04, 0.50 ± 0.04) and RIP3 (0.68 ± 0.02, 0.84 ± 0.05) in groups M and H were higher than those in group C (0.25 ± 0.01, 0.45 ± 0.04, P < 0.05). Conclusion:Subchronic arsenic exposure induces histopathological changes such as myocardial necrosis and fibrosis in mice, inducing necroptosis and inflammatory reactions in myocardial cells.

Objective:The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China.Methods:This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems.Results:According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%).Conclusion:Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.

Objective:To investigate the value of growth differentiation factor-15 (GDF-15) and extravascular lung water index (EVLWI) in severity grading and prognosis prediction of patients with acute respiratory distress syndrome (ARDS).Methods:Patients with ARDS aged 18-75 years admitted to the department of respiratory intensive care unit (RICU) of Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2019 to February 2020 were enrolled. All patients were treated with conventional therapies such as mechanical ventilation, anti-infection, stabilization of water, electrolytes and acid-base environment, blood purification and nutritional support according to their conditions. Besides, the pulse-indicated continuous cardiac output (PiCCO) was performed after admission to the department, and EVLWI before treatment and at 24, 48 and 72 hours of treatment were recorded. Serum GDF-15 level was measured by enzyme linked immunosorbent assay (ELISA) during the same period. Patients were classified as mild, moderate, and severe degree according to the 2012 Berlin Definition of ARDS, and EVLWI and GDF-15 levels in patients with different disease levels before and after treatment were compared. In addition, the length of intensive care unit (ICU) stay, ICU mortality, and 28-day mortality of patients with different GDF-15 or EVLWI levels were analyzed comparatively, with the GDF-15 3 458 ng/L and EVLWI 15 mL/kg as the cut point.Results:A total of 82 patients with ARDS were enrolled, including 22 patients with mild ARDS, 28 patients with moderate ARDS, and 32 patients with severe ARDS. The GDF-15 and EVLWI levels in patients with moderate and severe ARDS at each time point before and after treatment were higher than those in patients with mild ARDS. Both GDF-15 and EVLWI levels in patients with severe ARDS were higher than those in the patients with moderate ARDS. The differences were statistically significant at all the time points except for the difference of GDF-15 levels at 24 hours after treatment (ng/L: 3 900.41±546.43 vs. 3 695.66±604.73, P > 0.05). [GDF-15 (ng/L): 3 786.11±441.45 vs. 3 106.83±605.09 before treatment, 3 895.48±558.96 vs. 3 333.29±559.66 at 48 hours, 3 397.33±539.56 vs. 3 047.53±499.57 at 72 hours; EVLWI (mL/kg): 19.06±1.91 vs. 14.31±1.50 before treatment, 18.56±2.23 vs. 13.26±1.69 at 24 hours, 17.23±1.76 vs. 12.45±1.36 at 48 hours, 15.47±1.81 vs. 11.13±2.19 at 72 hours, all P < 0.05]. According to the cut-off value, there were 23 patients with GDF-15 ≥ 3 458 ng/L and GDF-15 < 3 458 ng/L respectively and there were 23 patients with EVLWI ≥ 15 mL/kg and EVLWI < 15 mL/kg respectively. The length of ICU stay and 28-day mortality in patients with high GDF-15 were significantly higher than those in patients with low GDF-15 [length of ICU stay (days): 21.22±2.69 vs. 15.37±3.14, 28-day mortality: 56.5% vs. 21.7%, both P < 0.05]. The length of ICU stay and 28-day mortality in patients with high EVLWI were also significantly higher than those in patients with low EVLWI [length of ICU stay (days): 18.45±2.61 vs. 14.98±2.75, 28-day mortality: 47.8% vs. 17.4%, both P < 0.05]. Conclusion:To some extent, GDF-15 and EVLWI levels reflect the severity of patients with ARDS, and high GDF-15 and EVLWI levels are significantly associated with poor prognosis in patients with ARDS.

Objective To investigate the safety and clinical efficacy of magnetic resonance neuronavigation assisted technique in neurosurgical clipping of pericallosal aneurysms. Methods From January 2010 to January 2017,40 consecutive patients with pericallosal aneurysm treated with neurosurgical clipping at the Department of Neurosurgery,the 175th Hospital of PLA were enrolled retrospectively. They were diagnosed by CT angiography (CTA),magnetic resonance angiography (MRA)or digital subtraction angiography (DSA)before operation. According to the different surgical methods,40 patients were divided into either a routine surgical group (n＝18)or a neuronavigation assistance group (n＝22). On the basis of the conventional longitudinal fissure approach,the neuronavigation assistance group was treated with the magnetic resonance neuronavigation technique. The aneurysms and upper drainage vein,design incision and surgical approaches were accurately located. The operation time,surgical complications (edema or infarction after drainage vein injury and secondary bleeding in the operated area)and proportion of good prognosis (the modified Rankin scale [mRS]score ＜3)were compared. Results (1)Under the microscope,40 patients underwent clipping of pericallosal aneurysms via longitudinal fissure approach. Postoperative CTA or DSA confirmed that they were all completed clipped. The operation time of the neuronavigation assistance group were shorter than that of the routine surgical group (2. 5 ± 0. 5 h vs. 3. 5 ± 0. 4 h,t＝1. 254),and the proportion of edema or venous infarction was less than that of the routine surgical group (4. 5%[1／22]vs. 6／18). The difference between the two groups was statistically significant (all P＜0. 05);there were no significant differences in the incidences of accidental rupture and secondary hemorrhage between the two groups (all P＞0. 05). (2)Both groups of patients completed the 6-month follow-up. There were 12 patients (12／18)with good prognosis in the routine surgery group and 20 (90. 9%)with good prognosis in the neuronavigation assistance group. There was no significant difference in the proportion of good prognosis between the two groups (χ2＝3. 545,P＞0. 05). Conclusions The use of magnetic resonance neuronavigation assisted technique helps the precise intraoperative positioning of the lesions and surgical approach optimization,thereby effectively implementing brain protection,reducing the risk of microsurgery, and improving the accuracy and safety of the surgery. It is an effective auxiliary means of neurosurgical clipping of pericallosal aneurysms.

Objective To analyze and summarize the clinical characteristics of patients with spontaneous hemor -rhage of hepatic adenoma in glycogen storage disease type Ⅰa.Methods Reporting 1 case in our hospital and making a summary about general situation , category, etiology, diagnosis and treatment of the hemorrhage of hepatic adenoma with glycogen storage disease type Ⅰa through checking literatures .Results The patient was a 27 year old male who had been diagnosed as glycogen storage disease for 14 years, as well as was first found hepatic adeno-ma at the age of 17 .He once was diagnosed as intra-adenoma bleeding with persistent abdominal pain and dizziness and was underwent selective hepatic artery embolization at the age of 22.Hepatic adenoma in glycogen storage dis-ease typeⅠa generally appeared at the age of puberty .One common complication of this disease was hemorrhage of hepatic adenoma , which can be found by ultrasonography and CT .Clinical management includs observation , selec-tive hepatic artery embolization , radiofrequency ablation , surgical resection and liver transplantation .Conclusions Glycogen storage disease type Ⅰa is an autosomal recessive genetic disease with hepatic adenoma as a common complication of GSD Ⅰa, serious liver adenoma's hemorrhage can be life threatening , the radiological examination can be helpful to detect hepatic adenoma .Then appropriate intervention can improve the life quality and prognosis .

Objective To study the quality testing of dose delivery system of the active spot scanning proton and heavy ion accelerator,in order to provide the reference for the quality control of related equipment.Methods In the four therapy rooms,both 0.6 cc chambers and Gafchromic EBT3 films were used,respectively,to test the accelerator for dose reproducibility,dose linearity,dose stability,depth dose distribution,beam scanning position deviation and radiation field uniformity in each therapy room.Results Dose reproducibility variation coefficients are all less than 1.5％,dose linearity's maximum deviations less than 2％,dose stability's deviations less than 2％,depth dose distribution stability within 2％,beam scanning position deviation less than 1 mm,consistency of irradiation field's deviation less than 2 mm,and flatness within ± 5％.Conclusions The indicators about quality testing for the active spot scanning proton and heavy ion accelerator are all in line with the requirements of IEC standards draft.

Objective To develop the method for testing the consistency of irradiation field produced by the active spot scanning proton and heavy ion accelerator.Methods Calibration of the EBT3 films were carried out with the calibrated ion beam to establish the dose calibration curve.According to the different proton and carbon ion energies (proton:94.29,150.68,212.62 McV;carbon ion:175.99,283.43,412.54 MeV/u),EBT3 films were located in the solid water phantoms in each therapy room,respectively.Finally,the irradiated EBT3 films were scanned and the radiation field size's deviation and flatness were analyzed.Results In different conditions,radiation field size's deviations were all less than 2 mm and the flatness parameters were all controlled below the 5％.Conclusions EBT3 films can be used to test the active spot scanning proton and heavy ion accelerator's radiation field uniformity.

Objective To investigate the detection rates and types of hemoglobinopathy in Xiaolan district of Zhongshan city to provide the basis for prepotency .Methods 7 652 pregnant women with pregnancy detection in our hospital from June 2010 to De‐cember 2013 were selected and performed the electrophoresis by the Hydrasys automatic hemoglobin electrophoresis system .The hemoglobin components were scanned out and performed the statistical analysis .Results Among 7 652 samples ,1 057 cases of sus‐pected hemoglobinopathy were screened out with the detection rate of 10 .36% .Among them ,511 cases(6 .68% ) were Hb A2 <2 .0% (suspected α‐thalassemia) ,451 cases(5 .89% ) were Hb A > 3 .5% (suspected β‐thalassemia) ,the detection rate of Hb A2 >3 .5% was lower than that of Hb A2 < 2 .0% ,the difference had statistical significance(P< 0 .05) .11 cases (0 .14% ) were Hb C or E ,9 cases (0 .12% ) were Hb J or K ,8 cases (0 .10% ) were Hb H ,7 cases (0 .09% ) were Hb Bart′s ,1 case was Hb CS ,2 cases were Hb G and 1 case was Hb D ,which accounted for 0 .04% .Conclusion Hemoglobin electrophoresis can screen hemoglobinopa‐thy effectively .The hemoglobinopathy screening in this area should be conducted as soon as possible ,which has an important signif‐icance to prepotency .