Objective:To comprehensively evaluate the performance of the iterative cone beam CT (iCBCT) imaging mode of Varian linear accelerators and to explore its specific advantages in clinical application.Methods:The kV cone beam CT (CBCT) imaging systems of Halcyon 2.0, Edge, and VitalBeam linear accelerators from Tianjin Medical University Cancer Institute & Hospital were selected, among which Halcyon 2.0 and Edge were equipped with the iCBCT imaging mode. The Penta-Guide phantom was used to evaluate the registration accuracy of iCBCT imaging modes. The accuracy of treatment couch position was measured by a ruler. The image quality of the iCBCT and conventional CBCT modes of various imaging devices were analyzed using the CatPhan604 phantom. The imaging beam-on time and reconstruction time were measured to assess image acquisition efficiency. The uniformity, spatial resolution, contrast, contrast-to-noise ratio (CNR), image acquisition time and reconstruction time between two imaging modes were statistically analyzed by t-test. Results:The maximum deviations of image registration measurement results of the iCBCT mode for Halcyon 2.0 and Edge accelerators compared to the standard values were 0.7 mm and 0.6 mm, respectively. The treatment couch position error of all devices was less than 1 mm. The iCBCT images under head scanning protocol primarily improved the uniformity and CNR. Compared to conventional CBCT images, Halcyon iCBCT increased the uniformity and CNR by 2.50% ( P<0.001) and 78.85% ( P<0.001), respectively, while Edge increased them by 2.18% ( P<0.001) and 86.42% ( P<0.001), both superior to VitalBeam CBCT images. Under pelvis scanning protocols, iCBCT images primarily improved the CNR compared to conventional CBCT images. Halcyon and Edge iCBCT increased the CNR by 113.57% ( P<0.001) and 133.87% ( P<0.001), respectively, both superior to VitalBeam CBCT images. In terms of image acquisition efficiency, the average reconstruction times for Halcyon and Edge iCBCT images increased by 7.28 s and 15.53 s, respectively, and the total image acquisition time of Halcyon accelerator was the shortest. Conclusions:While ensuring the registration accuracy, iCBCT imaging mode can significantly improve the CNR of images and improve the uniformity of images under head scanning protocol. The Halcyon imaging system can enhance image acquisition efficiency.

In recent years, the application of alpha particle-based nuclide targeted therapy in tumors has shown great potential. 225Ac is a nuclide that can be used for alpha radionuclide targeted therapy which has been studied at home and abroad. A number of preclinical and clinical trials have been carried out, and some achievements have been obtained. This article summarizes the current research status of several malignant tumors, and analyzes the challenges and progress faced by 225Ac in radionuclide targeted therapy.

Objective To investigate the influence of curcumin and its analogue H8 on glucose and lipid metabolism disorder in db/db mice. Methods The type 2 diabetes mouse model (db/db mice) was intragastrically administrated with curcumin and analogue H8 for 8 weeks.The blood biochemical indexes were measured.The expression of PEPCK and G6Pase mRNA was detected by real-time PCR in liver tissues.The expression of PEPCK and G6Pase protein was detected by Western blotting. Results Curcumin analogue H8 reduced blood glucose and lipids in db/db mice (P<0.01) and improved liver function related enzymes significantly.The levels of PEPCK and G6Pase mRNA in db/db mice were significantly decreased (P<0.01) and the expression levels of PEPCK and G6Pase protein were significantly decreased(P<0.01). Conclusion Curcumin analogue H8 improves the glucose and lipid metabolism disorder in db/db mice,and it is related to inhibiting the expression of PEPCK and G6Pase gene and protein.

Objective To study the inhibitory effect of curcumin on the proliferation,migration and invasion of non-small cell lung cancer cell A549,and to discuss further if it is closely related to the expression of c-Jun N-terminal kinase (JNK) and relative protein p38.Methods A549 cells were cultured by conventional method,and then treated with different concentration of curcumin (10,20,40,80 μmol · L-1).The proliferation,migration and invasion of A549 cells were measured by real-time cellular analysis (RTCA).The expression levels of JNK,p-JNK,p38 and P-p38 were detected by real-time PCR and Western blotting.Results Curcumin showed an antiproliferation effect against A549 cells with IC50 =40 μmol · L-1,and curcumin exhibited obviously inhibitory effect on the migration and invasion of A549 cells.Additionally,compared with control group,curcumin suppressed the expression of JNK and p38 at the gene level,and significantly inhibited the expression of JNK,P-JNK,p38 and p38 (P＜0.05) at the protein level.Conclusion These results demonstrated that curcumin can inhibit the proliferation,migration and invasion of A549 cells via reducing the level of JNK,p38 phosphorylation,and blocking JNK signal transduction pathway.

Objective To explore the clinical application value of a small sealed bottle in the pseudoaneurysm after coronary arteriography .Methods Sixty-four with pseudoaneurysm after coronary arteriography selected in second people ’ s hospital of Wuxi city were randomly divided into observation group and control group , 32 cases in each group .Control group received elastic bandage pressing arterial puncture part , while observation group received small sealed bottle pressing .Hamilton anxiety scale ( HAMA) was applied to evaluate the anxiety symptoms of patients in two groups , and the healed time , hospital stays and postoperative satisfactory degrees were also compared .Results The healed time [(2.7 ±0.6) d], hospital stays [(4.8 ±1.6)d] and anxiety symptom scores (1.9 ±0.8) in observation group were significantly shorter/lower than in control group [(5.4 ±1.3) d, (7.2 ±2.1) d, (2.7 ±1.1)], and all the differences had statistical significance (t=10.668,5.142,3.327,respectively;P<0.01).Besides, the satisfactory degree of patients in observation group (93.6%) was evidently higher than that in control group (65.6%), and statistically significance difference was presented (χ2 =7.819,P<0.01).Conclusions The local part bound up by elastic bandage in combination with a small sealed bottle pressed the arterial puncture part can obviously shorten the healed time and hospital stays of patients with pseudoaneurysm after coronary arteriography , promote the surgical limb recovery , alleviate anxiety symptoms and improve the patients ’ satisfactory degree , so it deserves to be popularized and promoted in clinic .

[Abstract] Objective To define the age-specific normal reference values of prostate specific antigen (PSA) and related parameters in Chinese middle-aged and elderly men.Methods From April 2007 to November 2011,serum PSAs of over 22 055 men aged more than 40 years old in our medical examination center were statistically analyzed.The men was divided into five groups by a 10-year-old interval.Total PSA (tPSA),free PSA (fPSA) and prostate ultrasound results were recorded.The free-total PSA ratio (f/t),PSA density (PSAD) and PSA velocity (PSAV) were calculated.By convention,the 95th percentile (P95)was used as the upper limit value,and the 5th percentile (P5) as the lower limit value.Results The tPSAs were positively correlated with age (r=0.349,P＜0.001).f/t was negatively correlated with age (r=-0.154,P＜0.01).Although f/t was significantly different (P＜0.001) among each age group,P5 of all groups were 0.18.PSAD was significantly different (P＜0.001) between men over and under 70 years,with P95 as 0.09 and 0.15,respectively.PSAD had a positive correlation with age (r =0.263,P＜0.01).The significant difference of PSAV raised between men over and under 60 years,with P95 as 0.21 and 0.58,respectively.PSAV was positively correlated with age (r=0.130,P＜0.01).Conclusions PSA,PSAD and PSAV are positively correlated with age,while f/t is negatively correlated with age.The normal range of f/tis 0.18-1.00 for Chinese men over 40 years old.PSAD's normal ranges are ＜0.09 and ＜0.15 in Chinese men over and under 70 years,respectively.The normal range of PSAV are ＜0.21 and ＜0.58 for Chinese men over and under 60 years,respectively.

Objective To evaluate the effect of transurethral feedback microwave thermotherapy with the ProstaLund CoreTherm Device (PLFT) in benign prostate hyperplasia ( BPH ) patients with high risk factors 24 months after treatment.MethodsSixty-two BPH cases with high risk factors of aged ≥ 80or complicating severe conditions of no less than one organ or system,were treated with PLFT under urethral local anesthesia.The average pre-treatment prostate volume,international prostate symptom score (IPSS),quality of life score (QOL) and maximal urinary flow (Qmax) were 62.03 ml,23.19,4.58 and 4.33 ml/s,respectively.The changes of prostate volume,IPSS,QOL and Qmax at 3 months,12 months and 24 months after treatment were analyzed.ResultsAll patients tolerated well of PLFT performed in common therapy room except lightly bleeding,minor infection and temporary incontinence.There was no severe surgical adverse event.After 3 months,the prostate volume reduced to 43.85 ml,IPSS decreased to 11.63,QOL decreased to 2.44,Qmax rose up to 11.44 ml/s； The average values were 45.10 ml,12.23,2.61 and 10.91ml/s at 12 months after treatment.The corresponding values were 45.80 ml,12.37,2.66 and 10.82 ml/s,respectively at 24 months after treatment.Compared with pre-treatment,all the parameters showed significant improvement ( P ＜ 0.01 ).ConclusionsPLFT is one of the effective and safe treatment options for BPH patients with high risk factors.It can be safely used on day-surgery patients.The best effect appears at 3 months after treatment.

ObjectiveTo evaluate the value of intraoperative frozen section examination (IFS) in the diagnosis and surgical procedures selection for renal occupying lesions. MethodsFrom January 2006 to December 2010,IFS was used in 114 men and 81 women with renal occupying lesions.The mean age was 52 years (range 17 -78).In 104,89,and 2 patients,lesions were in the right,left and bilateral kidneys,respectively.All patients underwent physical examination,129 were asymptomatic at presentation while clinical symptoms were observed in 66.The largest dimension of the tumors were 4 cm or less in 128 patients,4- 7 cm in 49,and larger than 7 cm in 18,respectively.The outcomes between IFS and postoperative routine paraffin section examination were compared.In cases with renal tumors nephrectomy or partial nephrectomy was performed.The results of IFS were compared between the 2 groups. ResultsThe sensitivity and specificity of IFS for renal malignant lesions was 96.6％ and 100％,respectively.The total accuracy rate of IFS for renal occupying lesions was 97.4％.By subgroup analysis,the accuracy rate of clear cell carcinoma,papillary cell carcinoma,chromophobe cell carcinoma,sarcomatoid cancer,nephroblastoma,benign tumor and urothelial cancer was 94.3％,25.0％,16.7％,0,0,97.6％ and 100.0％,respectively.Partial nephrectomy and nephrectomy were performed in 57 and 123 patients with renal tumors,respectively.The surgical procedures selection was significantly associated with the lesion size (4 cm or less for 80.7％ vs 62.6％,P =0.015) and the malignant lesion diagnosed by IFS (31.6％ vs 93.5％,P＜0.001). Conclusion The accuracy of frozen section analysis for renal malignant lesions during surgery is reliable and significantly high,and the results can exert an important impact on surgical procedures selection.

Objective To evaluate the efficacy in treatment with transurethral electrocision for prostatic cyst.Methods A total clinical documents of 15 cases prostatic cyst treated with transurethral electrocision were analyzed retrospectively.All the cases were diagnosed confirmly by ultrasonography and CT,all the cysts closed to the prostatic urethra or intrude urinary bladder and all the patients underwent transurethral electrocision.Results All operations were performed successfully with operative time of 18-60 (36 ± 13) min.No blood transfusion during and after the operation and postoperative hospital stay was (5.2 ± 2.6) d.All the patients had been followed up for 6-24 months,the clinic symptom disappeared and no complications happened.Three months after the operation,IPSS decreased from (27.2 ±5.6) scores to (7.5 ± 1.6) scores and QOL decreased from (4.5 ± 1.1 ) scores to ( 1.6 ± 0.6) scores (P＜ 0.01 ),respectively.Qmax increased from (6.8 ±2.3) ml/s to (22.4 ±4.8) ml/s (P ＜0.01).Conclusion Transurethral electrocision is an effective therapeutic measure of prostatic cyst close to the prostatic urethra or intrude urinary bladder without so many complications.

Objective To evaluate the value of renal parenchymal volume and thickness by non-contrast spiral CT in evaluating the differential glomerular filtration rate (GFR) for chronic obstructed kidneys, and to compare the correlations between the two morphologic indices of renal parenchyma and the GFR for chronic obstructed kidneys. Methods Seventy-one patients who had a diagnosis of unilateral chronic upper urinary tract obstruction were included in this analysis. (1) The renal parenchymal volume was mea-sured by non-contrast spiral CT. Both kidneys were scanned by non-contrast spiral CT. The renal parenchymal area of each section was marked manually. Renal parenchymal volume was calculated as the sum of renal parenchymal area multiplied by the width of each section. The volume percentage of obstructed kidney (%CTvol) was also calculated. (2) Renal parenchymal thickness was measured on the first and last non-contrast CT image levels from the anterior, posterior and lateral locations of the kidney that clearly contained the collecting system. The mean of these measurements was defined as the renal parenchymal thickness. The differential renal parenchymal thickness of the obstructed kidney (%CTt) was defined as the percentage of the obstructed renal parenchymal thickness to the total renal parenchymal thickness for both kidneys. GFR was determined with 99Tcm-DTPA dynamic imaging system by Gates method. The differential GFR for obstructed kidney (%GFR) was the GFR percentage of obstructed kidney to the total GFR for both kidneys. The Pearson relation test was carried out between the %CTvol, %CTt and the %GFR respectively. Results %CTvol and %CTt correlated well with %GFR in chronic obstructed kidneys among the 71 test group patients. Pearson correlation coefficient r was 0.80 (t=11.20, P＜0.05) and 0.66 (t=7.24, P＜0.05), respectively. The linear correlation equation respectively was %GFR=0.05+0.80×%CTvol (F=125.48, P＜0.05) and %GFR=0.12+0.66×%CTt (F=52.36, P＜0.05). Conclusions Renal parenchymal volume and thickness by non-contrast spiral CT might be used as clinical practical parameters to evaluate the differential GFR for chronic obstructed kidneys. Renal parenchymal volume is more accurate than renal parenchymal thickness.