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Objective To analyze the performances of electronic portal imaging device (EPID) in mechanical and dosimetry responses,and to investigate the feasibility of adopting EPID as a daily quality assurance (QA) equipment. Methods The EPID of Trilogy linear accelerator was tested for mechanical position repeatability and dose linear response. Then,a group of special fields were edited manually for simulations of field translation and symmetry deviations,and the sensitivities of EPID and MyQA Daily to field translation and symmetry deviations were evaluated,and moreover,the linear correlation between the set value and the measured value was analyzed. Finally,daily QA was conducted with EPID and MyQA Daily for 30 consecutive days,and the measurement results and time consumption were analyzed. Results The maximum deviation of EPID position repeatability was 0.4 mm,and the dose response was linearly correlated (R2>0.999). The symmetry deviation test results showed that both of EPID and MyQA Daily were capable to effectively detect the 0.2％ offset in symmetry,and a linear correlation was demonstrated between the set value and the measured results (R2>0.995). In translation test,the linear correlation of EPID was more explicit than that of MyQA Daily (R2=0.992 vs R2=0.976). In daily QA,all the measured results of EPID and MyQA Daily were within the clinic acceptance tolerance. Moreover,the mean value of Y-directional symmetry and flatness measured by EPID was approximately 1.00％ larger than MyQA Daily. The average time required by EPID was 50 s less than MyQA Daily[(129.97±4.16) s vs (184.53±4.23) s]. Conclusion EPID can be served as a reliable and efficient daily QA equipment for linear accelerator. However,it is not capable to be used as a criterion for evaluating linear accelerator performance.

Objective To analyze the performances of electronic portal imaging device (EPID) in mechanical and dosimetry responses,and to investigate the feasibility of adopting EPID as a daily quality assurance (QA) equipment. Methods The EPID of Trilogy linear accelerator was tested for mechanical position repeatability and dose linear response. Then,a group of special fields were edited manually for simulations of field translation and symmetry deviations,and the sensitivities of EPID and MyQA Daily to field translation and symmetry deviations were evaluated,and moreover,the linear correlation between the set value and the measured value was analyzed. Finally,daily QA was conducted with EPID and MyQA Daily for 30 consecutive days,and the measurement results and time consumption were analyzed. Results The maximum deviation of EPID position repeatability was 0.4 mm,and the dose response was linearly correlated (R2>0.999). The symmetry deviation test results showed that both of EPID and MyQA Daily were capable to effectively detect the 0.2％ offset in symmetry,and a linear correlation was demonstrated between the set value and the measured results (R2>0.995). In translation test,the linear correlation of EPID was more explicit than that of MyQA Daily (R2=0.992 vs R2=0.976). In daily QA,all the measured results of EPID and MyQA Daily were within the clinic acceptance tolerance. Moreover,the mean value of Y-directional symmetry and flatness measured by EPID was approximately 1.00％ larger than MyQA Daily. The average time required by EPID was 50 s less than MyQA Daily[(129.97±4.16) s vs (184.53±4.23) s]. Conclusion EPID can be served as a reliable and efficient daily QA equipment for linear accelerator. However,it is not capable to be used as a criterion for evaluating linear accelerator performance.

Objective:To explore the risk factors of recurrence after resection of thigh soft tissue malignant tumors and the evaluation of the postoperative lower limb function.Methods:A total of 211 patients who underwent thigh soft tissue malignant tumor resection in the Department of Orthopaedics of the second affiliated Hospital of Medical College of Zhejiang University from May 2011 to May 2021 were retrospectively analyzed, including 117 males and 94 females, aged 53 (43, 65) years. There were 59 cases of atypical/well-differentiated liposarcoma, 30 cases of other types of liposarcoma, 33 cases of malignant fibrous histiocytoma, 19 cases of fibrosarcoma, 12 cases of rhabdomyosarcoma, 12 cases of leiomyosarcoma, 9 cases of synovial sarcoma, and 37 cases of others. The tumor involvement of muscle, bone, blood vessel, nerve tissue and intermuscular compartment, postoperative Musculoskeletal Tumor Society (MSTS) functional score and recurrence were recorded. The relationship between anatomical structure and postoperative recurrence was analyzed by Cox logistic regression to determine risk factors; the cumulative recurrence rate of different compartment groups (medial compartment, anterior compartment, and posterior compartment) were compared; The Box plot was used to compare the postoperative function of patients with resection of different anatomical structures (e.g., vastus lateralis, biceps femoris, femur, etc.).Results:A total of 34 out of 211 patients relapsed, with a recurrence rate of 16.1%. The recurrence time ranged from 2.6 months to 91.6 months after operation, with a median recurrence time of 37.0 (18.2, 52.8) months. Three independent risk factors were found to be associated with recurrence, namely: pathological grade [ HR=3.86, 95% CI(1.75, 8.51)], involvement of vastus intermedius [ HR=3.05, 95% CI(1.53, 6.06)], and involvement of vastus medialis [ HR=3.17, 95% CI(1.56, 6.41)]. The recurrence rate of patients with anterior chamber tumor resection was 35.3%, which was higher than that of patients without tumor resection (16.2%), and the difference was statistically significant ( P=0.020). There was no significant difference in recurrence rate between patients with medial chamber tumor resection and patients without tumor resection ( P>0.05). The recurrence rate of patients with posterior compartment tumor resection was 12.3%, which was lower than that of unresectable patients (37.6%), and the difference was statistically significant ( P=0.002).The postoperative MSTS score of 167 patients averaged 26±3.2 points (9-30 points). After intraoperative resection of part of the femur, vastus intermedius, vastus medialis, and rectus femoris, the patient's function was relatively poor [corresponding median MSTS score: 25 (23, 28), 26 (24 28), 26 (24,28), 26(24, 27)]. Conclusion:The risk factors for local recurrence after resection of thigh soft tissue malignant tumors include: pathological grade of the tumor, and whether the vastus intermedius or vastus medialis is involved. Anterior compartment tumors have a higher recurrence rate after surgery. If the tumor involves the above-mentioned anatomical structures, more attention should be paid to the risk of local recurrence after surgery.

Idiopathic pulmonary fibrosis (IPF) is a chronic progressive lung disease characterized by progressive lung fibrogenesis and histological features of usual interstitial pneumonia. IPF has a poor prognosis and presents a spectrum of disease courses ranging from slow evolving disease to rapid deterioration; thus, a differential diagnosis remains challenging. Several biomarkers have been identified to achieve a differential diagnosis; however, comprehensive reviews are lacking. This review summarizes over 100 biomarkers which can be divided into six categories according to their functions: differentially expressed biomarkers in the IPF compared to healthy controls; biomarkers distinguishing IPF from other types of interstitial lung disease; biomarkers differentiating acute exacerbation of IPF from stable disease; biomarkers predicting disease progression; biomarkers related to disease severity; and biomarkers related to treatment. Specimen used for the diagnosis of IPF included serum, bronchoalveolar lavage fluid, lung tissue, and sputum. IPF-specific biomarkers are of great clinical value for the differential diagnosis of IPF. Currently, the physiological measurements used to evaluate the occurrence of acute exacerbation, disease progression, and disease severity have limitations. Combining physiological measurements with biomarkers may increase the accuracy and sensitivity of diagnosis and disease evaluation of IPF. Most biomarkers described in this review are not routinely used in clinical practice. Future large-scale multicenter studies are required to design and validate suitable biomarker panels that have diagnostic utility for IPF.
Humans ; Idiopathic Pulmonary Fibrosis/diagnosis* ; Biomarkers ; Lung Diseases, Interstitial ; Lung ; Bronchoalveolar Lavage Fluid ; Disease Progression ; Prognosis

This paper introduces the design and development of a light-weighted medical equipment management system in hospital based on structured information flow architecture, to collect and analyze data in medical equipment lifecycle management processes. It applies co-operative work flows both online and off-line to achieve high quality data collection, and to increase the efficiency for clinical personals and clinical engineers. This system manages to apply the UDI system, implements the intelligent access to medical equipments, uses data analysis to provide intelligent services. It will boost the quality control management and information construction synchronously.
Equipment and Supplies ; Hospitals ; Materials Management, Hospital ; Quality Control

As national strategic resources,traditional Chinese medicine (TCM) resource is the material basis for the pharmaceutical industry and health services.The high-efficiency utilization of TCM resource is a major strategic issue that realize the resource conservation and environment friendly recycling economy,guarantee the sustainable development of medicine.But currently,on one hand,the wild TCM resource was seriously damaged and in a serious shortage of stock,the cultivation variety was degenerated,the tending of endangered medicinal materials and the development of alternative varieties were faced many problems.On the other hand,the limited resources cannot be effectively utilized,which results in the waste of resources.Therefore,two ecological restricted resources,poria cocos and Chinese gall,were studied for comprehensive utilization of resources to explore the comprehensive exploitation and utilization of TCM resource as well as the pattern of sustainable development.We suggested that TCM resource should be taken into account as a whole for comprehensive utilization.We should especially pay attention to basic research for the sustainable development of TCM resource,discovery of bioactive substance,excavation and transformation for functional components,the use of biotechnology,the product development,the formation and extension of industry chain.So as the comprehensive exploitation and utilization of TCM resources and sustainable development would be realized.

Children usually come to emergency department accompanied with painful conditions and injuries.During the emergence care,additional painful,distressing or unpleasant diagnostic and therapeutic procedures may be required.Emergency doctors are anticipated to provide safe and effective analgesia and se-dation for children.This review summarized recent studies on the following aspects:make sure that children do not experience lengthened or additional pain when coming to emergency medical care;at triage use a com-posite pain assessment tool to assess;aim to provide effective analgesia at the first attempt-use the appropriate drug,dose,and route;choose painless modes of delivery(nasal route,flavoured syrups) if possible;reassess frequently pain scores to make sure that analgesia is effective and allow adequate time for it to work;use non-pharmacological and pharmacological modalities to manage pain;avoid the"routine"use of unnecessary painful invasive procedures;use topical,local and regional anaesthesia together with proper safe procedural se-dation to avoid further pain.

The in-vitro fertilization and embryo transfer technique has been widely applied in human insemination. The rate of successful insemination is gradual y rising, and the in-vitro fertilization directly determine the insemination outcome.
OBJECTIVE:To evaluate the difference between the two common using insemination methods, microdrop and open, in in-vitro fertilization and embryo development.
METHODS:A randomized study was conducted to compare microdrop and open insemination methods among non-male factor patients undergoing in-vitro fertilization and embryo transfer. A total of 1 175 cases were enrol ed in the research. There were 573 cases in the microdrop group, and 602 cases in open insemination group. The fertilization rate and embryo development in the two groups were compared.
RESULTS AND CONCLUSION:The fertilization failure rate [total fertilization failure rate+low fertilization rate (<25%oocytes fertilized)] in the microdrop insemination group was higher than in the open insemination group (11.9%, 3.3%, P<0.001), while the good quality embryo rate and pregnancy rate did not differ significantly between the two groups (al P>0.05). The open insemination method is a simple insemination method with a lower fertilization failure rate. As the fertilization is a highly complicated process involving many extrinsic and intrinsic factors, further study is needed to confirm the effects of the two insemination methods on in-vitro fertilization outcome.

AIM: To down-regulate expression of c-myc through antisense therapy and to investigate its effect on the sensitivity of osteosarcoma MG-63 cells to cisplatin-induced apoptosis. METHODS: The recombinant adenovirus (Ad-Asc-myc) encoding antisense c-myc fragment was constructed and transfected into osteosarcoma MG-63 cells in vitro in order to down-regulate the expression of c-myc, and the change in the sensitivity to cisplatin-induced apoptosis was observed. MTT, Western blot, RT-PCR, flow cytometry (FCM) and electron microscope were used to evaluate tumor cell proliferation in vitro, genes expression related to apoptosis regulation and effects on the sensitivity of osteosarcoma MG-63 cells to cisplatin-induced apoptosis. RESULTS: Ad-Asc-myc down-regulated the expression of c-myc protein after transfected MG-63 cells for 48 h, combined with the treatment of 2.0 mg/L cisplatin for 2 h inhibited tumor cell proliferation in vitro by 38.0%. RT-PCR revealed that Ad-Asc-myc down-regulated the expression of Bcl-2 and up-regulated the expression of Bax. No appreciable change was observed in the expression of E_2F-1. FCM showed that Ad-Asc-myc induced apoptosis in intransfected cells, and rendered it more sensitive to cisplatin. CONCLUSION: Antisense c-myc is able per se to induce apoptosis and sensitize osteosarcoma cells to cisplatin-induced apoptosis.