Objective:To study the influence of image panel of different source image distances(SID)of beam central axis of Portal Dosimetry(PD)dose verification system on the verification of volumetric modulated arc therapy(VMAT)plan,so as to provide reference for dose verification in selecting the appropriate SID position and evaluation criteria.Methods:From July 2022 to May 2024,10 patients,who received radiotherapy on tumor at different-site in Specialized Medical Center of the Chinese People's Armed Police Force,were selected.All patients underwent VMAT.Ten simulated dose verification plans were established according to the data of patients,with a total of 10 arcs.The non-crystalline silicon image panel was calibrated at 0,-30,-40,-50 and-60 cm from the isocenter on the beam central axis,and the verification plans of PD system were established.Dose verification was carried out using electronic portal imaging device(EPID)(a-Si EPID)of non-crystalline silicon image panel that was onboard by accelerator.The γ pass rates under the standards of 3%/3 mm and 3%/2 mm were compared and analyzed.Results:Under the evaluation standard of 3%/3 mm,the γ pass rates of the collected doses were(98.93±0.81)%,(94.77±9.00)%,(92.18±11.34)%,(89.72±12.54)%and(87.05±13.06)%when the SID values were respectively 100,130,140,150 and 160 cm,which were all higher than these under the evaluation standard of 3%/2 mm,and the differences were statistically significant(t=2.75,3.44,3.59,4.16,6.47,P<0.05).There were significant differences between the average γ pass rate of the collected dose under evaluation standards of 3%/3 mm and 3%/2 mm when SID was 100cm,and the 100%of γ pass rate(t=-3.21,-3.62,P<0.05),while the differences of the obtained γ pass rates among other SID positions were not statistically significant(P>0.05).Conclusion:Under the evaluation standards of 3%/3 mm and 3%/2 mm,the γ pass rate of the collected dose at SID 100 cm is the highest.The γ pass rate of the collected dose at SID 130 cm can meet the basically clinical requirements.In EPID dose verification,the collection for dose should be prioritized for selection when SID was 100 cm,and the γ pass rate of dose verification is higher,the influence of interference is less at this time,which verification results have higher credibility.

Objective:To investigate any effect of aerobic exercise on the functioning of endothelial progenitor cells (EPCs) and on the Akt/eNOS signaling pathway in type 2 diabetes.Methods:Forty-five 6-week-old Sprague-Dawley rats free of specific pathogens were randomly divided into a normal control group, a diabetic model group and an exercise group. Type 2 diabetes mellitus was induced in the model and exercise groups by feeding a high-fat diet and streptozotocin injection. After successful modeling, the exercise group underwent 8 weeks of non-weight-bearing swimming training after which blood was collected from their abdominal aortas to measure EPCs, serum nitric oxide and the level of vascular endothelial growth factor (VEGF). Bone marrow-derived EPCs were isolated from the rats′ femurs and tibias for in vitro culture. The cells′ tube formation capacity was assessed using Matrigel assays, while the expression of protein kinase B (Akt) and endothelial nitric oxide synthase (eNOS) were determined using western blotting.Results:Compared with the normal group, the model group exhibited significantly reduced counts of EPCs in their peripheral blood. Serum NO and VEGF were also significantly lower, on average, and tube formation capacity was significantly impaired. p-Akt and p-eNOS protein expression were significantly downregulated. In contrast, the exercise group showed significantly increased EPC counts, elevated serum NO and VEGF levels, improved tube formation, and upregulated p-Akt and p-eNOS expression compared with the model group.Conclusions:Aerobic exercise improves EPC functioning in diabetic rats, and its mechanism may be associated with the regulation of the Akt/eNOS signaling pathway.

Objective:To study the influence of image panel of different source image distances(SID)of beam central axis of Portal Dosimetry(PD)dose verification system on the verification of volumetric modulated arc therapy(VMAT)plan,so as to provide reference for dose verification in selecting the appropriate SID position and evaluation criteria.Methods:From July 2022 to May 2024,10 patients,who received radiotherapy on tumor at different-site in Specialized Medical Center of the Chinese People's Armed Police Force,were selected.All patients underwent VMAT.Ten simulated dose verification plans were established according to the data of patients,with a total of 10 arcs.The non-crystalline silicon image panel was calibrated at 0,-30,-40,-50 and-60 cm from the isocenter on the beam central axis,and the verification plans of PD system were established.Dose verification was carried out using electronic portal imaging device(EPID)(a-Si EPID)of non-crystalline silicon image panel that was onboard by accelerator.The γ pass rates under the standards of 3%/3 mm and 3%/2 mm were compared and analyzed.Results:Under the evaluation standard of 3%/3 mm,the γ pass rates of the collected doses were(98.93±0.81)%,(94.77±9.00)%,(92.18±11.34)%,(89.72±12.54)%and(87.05±13.06)%when the SID values were respectively 100,130,140,150 and 160 cm,which were all higher than these under the evaluation standard of 3%/2 mm,and the differences were statistically significant(t=2.75,3.44,3.59,4.16,6.47,P<0.05).There were significant differences between the average γ pass rate of the collected dose under evaluation standards of 3%/3 mm and 3%/2 mm when SID was 100cm,and the 100%of γ pass rate(t=-3.21,-3.62,P<0.05),while the differences of the obtained γ pass rates among other SID positions were not statistically significant(P>0.05).Conclusion:Under the evaluation standards of 3%/3 mm and 3%/2 mm,the γ pass rate of the collected dose at SID 100 cm is the highest.The γ pass rate of the collected dose at SID 130 cm can meet the basically clinical requirements.In EPID dose verification,the collection for dose should be prioritized for selection when SID was 100 cm,and the γ pass rate of dose verification is higher,the influence of interference is less at this time,which verification results have higher credibility.

Objective:To investigate any effect of aerobic exercise on the functioning of endothelial progenitor cells (EPCs) and on the Akt/eNOS signaling pathway in type 2 diabetes.Methods:Forty-five 6-week-old Sprague-Dawley rats free of specific pathogens were randomly divided into a normal control group, a diabetic model group and an exercise group. Type 2 diabetes mellitus was induced in the model and exercise groups by feeding a high-fat diet and streptozotocin injection. After successful modeling, the exercise group underwent 8 weeks of non-weight-bearing swimming training after which blood was collected from their abdominal aortas to measure EPCs, serum nitric oxide and the level of vascular endothelial growth factor (VEGF). Bone marrow-derived EPCs were isolated from the rats′ femurs and tibias for in vitro culture. The cells′ tube formation capacity was assessed using Matrigel assays, while the expression of protein kinase B (Akt) and endothelial nitric oxide synthase (eNOS) were determined using western blotting.Results:Compared with the normal group, the model group exhibited significantly reduced counts of EPCs in their peripheral blood. Serum NO and VEGF were also significantly lower, on average, and tube formation capacity was significantly impaired. p-Akt and p-eNOS protein expression were significantly downregulated. In contrast, the exercise group showed significantly increased EPC counts, elevated serum NO and VEGF levels, improved tube formation, and upregulated p-Akt and p-eNOS expression compared with the model group.Conclusions:Aerobic exercise improves EPC functioning in diabetic rats, and its mechanism may be associated with the regulation of the Akt/eNOS signaling pathway.

With the reform of the medical and health system entering a critical period,public hospitals have also exposed new risks and challenges in economic operation.As an important means of hospital standardized management,internal control can better prevent and resolve the risk of hospital economic operation and ensure the sustainable operation of the hospital.By interpreting the requirements of current national policies on hospital internal control,it analyzes the functional positioning of financial and accounting supervision in hospital internal control,shares the internal control implementation path of sample hospitals from the perspective of financial and accounting supervision,and puts forward suggestions on strengthening internal control construction of public hospitals in the new era,in order to lay a good foundation for the high-quality development of hospitals.

Objective To investigate the efficacy of drug-coated balloon in treatment of femoropopliteal artery occlusive disease.Methods The clinical data of 49 patients with femoropopliteal artery occlusive disease from Feb 2016 to Oct 2017 were retrospectively analyzed.25 cases underwent drugcoated balloon treatment (DCB group),and 24 cases received plain balloon angioplasty (POBA group).Results The procedures were successful in all cases.There were no amputation or death occurred.In DCB group compared to POBA group,the patency rate at postoperative 3 months were not significantly different (96.0％ vs.87.5％,P ＞ 0.05),while it was significantly different at postoperative 6 and 12 months (88.0％ vs.66.7％;80.0％ vs.50.0％,both P ＜0.05).Minimal lumen diameter (MLD) changes and late lumen loss(LLL):The MLD in preoperative,immediate postoperative was not statistically significant between the three group(P ＞ 0.05).At 6 months and 12 months after operation,MLD of DCB group was higher than POBA group (P ＜ 0.05).At 12 months after surgery,LLL in DCB group was significantly lower than the POBA group (P ＜ 0.05).Conclusion DCB is the effective method to treat femoropopliteal artery occlusive disease,which has better short and mid-term efficacy than POBA.

Objective To evaluate the safety and efficacy of SilverHawk directional atherectomy device in the treatment of femoropopliteal occlusive disease. Methods From August 2012 to June 2014,46 patients(58 limbs)with femoropopliteal occlusive diseases in the treatment by SilverHawk directional atherectomy device were analyzed retrospectively . The mean lesion length and degree of diameter stenosisin the femoropopliteal stenoses(52 limbs) were (4.6 ± 2.3) cm and (85.6 ± 11.3)％.The mean lesion length in the femoropopliteal occlusions(6 limbs)was(6.3 ± 3.2)cm. Rutherford score was 3 ～ 5. Mean ABI was 0.45 ± 0.36. Patency was evaluated with color duplex sonography,CTA and DSA postoperatively. Results 46 patients(58 limbs)were recanalizated suc-cessfully via intraluminal approach. The overall technical success rate was 100％. The procedural success rate was 93.10％. Postoperative residual stenosis and ABI were(10.3 ± 6.2)％and 1.05 ± 0.32,which had statistical diff erence compared with preoperative(t=5.83,P=0.02). The average period of follow-up was 22 months. Mean ABI during the follow-up was 0.96 ± 0.15,which had statistical difference compared with preoperative(t = 5.09,P =0.03). The 6-month and 1-and 2-year primary patency rate was 94.83％、91.38％、84.48％,and secondary patency rate was 98.28％、96.55％、93.10％,respectively. Conclusion SilverHawk directional atherectomy device is safe and effective in treament offemoropopliteal occlusive disease ,with satisfactory early-middle results.

Objective To explore the improving safety measures of colon interposition after esophagectomy .Methods From January 2003 to December 2014, 65 cases of colon interposition after esophagectomy were performed, and some improve-ments were made in the methods and procedures .Mainly including: Preoperative evaluation to first operation; Selection of co-lon segment; Simplify vascular anatomy;Cervical anastomosis was replaced by intrathoracic anastomosis;Modified anastomosis sequence; Strengthen preoperative preparation.Results There were no perioperative deaths.Only 2 patients with cervical fis-tula, due to malnutrition automatically discharged.The rate of anastomotic leakage on neck were 27.77%(10/36) and 6.89%(2/29) in the chest.2 cases were completed intestinal obstruction after jejunostomy , 1 cases of volvulus and 1 cases of intus-susception confirmed by reoperation.Conclusion Colon interposition after esophagectomy is a very important way of surgery. The operation process is complex, but as long as mastering the point of surgery, improving the surgical procedures, the good effect can be obtained and greatly improve the safety of the operation .

Objective To evaluate the efficacy of acupuncture for tinnitus, hearing loss in patients with type 2 diabetes using the twirling, reinforcing-reducing method. Methods A total of 132 tinnitus, hearing loss patients with type 2 diabetes were included and divided into an observation group and a control group by random number table method, 66 in each group. Patients in both groups were acupunctured at Tinggong, Tinghui, Yifeng in the affected side, and Zhongzhu, Waiguan, Sanyinjiao, Taichong and Taixi in the both sides. Patients in the observation group were acupunctured at Taichong using the twirling reducing method, Taixi using the twirling reinforcing method, and those in the control group both of Taichong and Taixi using the needle retention method. Patients in both groups were also treated with semiconductor laser therapy and ultrashort wave therapy. All patients were treated for 1 month. The severity of tinnitus was assessed by the Tinnitus Severity Scale, and the clinical efficacy was evaluated. Results After the treatment, the Tinnitus Severity Scale score in the observation group was significantly lower than that in the control group (5.71 ± 2.19 vs. 7.14 ± 3.36;t=2.897, P<0.01). The significant improvement rate in tinnitus in the observation group was significantly higher than that in the control group (77.3%vs. 63.6%;χ2=22.091, P<0.01). The significant improvement rate in hearing loss in the observation group was no significant difference than that in the control group (72.4% vs. 63.8%; χ2=0.992, P=0.319). Conclusion Acupuncture using the twirling, reinforcing-reducing method may relieve tinnitus in tinnitus, hearing loss patients with type 2 diabetes.