The human body's structure and function are complex,encompassing five viscera,six bowels,as well as differences in qi,blood,yin,and yang.However,the fundamental life activity primarily relies on the body's yang.Physiologically,when the body has sufficient yang and smooth blood circulation without stagnation,the five organs are nourished,ensuring their proper function.Conversely,pathologically,the deficiency of yang caused by cold injury leads to blood stagnation and prolonged stasis,resulting in inadequate nourishment of the five viscera and subsequent dysfunction.Depression is a condition that can be triggered by cold condensation and blood stasis.Acupuncture treatment follows the principle of warming yang and activating blood circulation.Key acupuncture points such as Baihui(GV20),Dazhui(GV14),Zhiyang(GV9),Mingmen(GV4),Guanyuan(CV4),and Zusanli(ST36)are used to warm yang and replenish qi,while Xuehai(SP10),Weizhong(BL40),and Sanyinjiao(SP6)are utilized to activate blood circulation and open up the veins.Additionally,supplementary points like Danzhong(CV17),Zhongwan(CV12),Qihai(CV6),Hegu(LI4),and Taichong(LR3)are employed to regulate qi and alleviate stagnation,facilitating the smooth flow of qi and blood.This comprehensive approach addresses both the symptoms and the root cause,simultaneously addressing deficiencies and replenishing the body.It aims to restore deficient yang,resolve blood stasis,promote the full and calm flow of qi and blood,nourish the five viscera and restore their proper function,ultimately leading to the self-healing of depression.

Objective:To explore the application of ArcCheck system in the validation of Helical and Direct tomotherapy plans for esophageal cancer and summarize relevant experience.Methods:The Helical and Direct tomotherapy verification plans were established for 32 patients with esophageal cancer at different positions according to the doctor′s instructions, which were verified by the ArcCHECK system to compare the passing rate of the results.The correlation between the volume of the target area and the passing rate of the planned verification was analyzed. The therapeutic verification plan with a small target volume was made. The target area was placed at the center of ArcCHECK phantom and the area of detectors to statistically compare the verification passing rates.Results:Helical plan showed a significantly higher passing rate than the Direct plan ( P<0.01). The correlation coefficients between the target volume and the passing rate of the Helical and Direct plans were -0.364 and -0.042, and the P values were 0.041 and 0.819, respectively. For the Helical plan, when the 3%/2mm criterion was adopted, there was significant difference between placing the high-dose area at the center of the phantom and the area of detectors ( P=0.005), and the passing rate of the latter was higher. There was no significant difference in the other cases (all P>0.05). Conclusions:The passing rate of the Helical plan is generally higher than that of the Direct plan, which may be related to the angular response of the ArcCHECK detector and the fact that more reference points are not included for calculation due to low-dose radiation. In addition, it may also be related to the higher requirements of Direct plan for tomotherapy dose control system. In the Helical verification plan, when the 3%/3mm criterion is adopted, the larger the target volume, the higher the possibility of lower passing rate, whereas the correlation coefficient between them is relatively low. The high-dose area can be verified by the plans at the center of the phantom or the detection point. With the comprehensive consideration, we suggest putting it at the center of the phantom.

Objective To analyze setup errors and guide the calculation of margins from clinical target volume (CTV) and planning target volume (PTV) in esophageal cancer patients treated with tomothcrapy by the MVCT image-guided system.Methods Sixty-four esophageal canccr patients trcated with tomotherapy in our hospital in 2016 were randomly selected.MVCT images were acquired after patients' positioning and co-registered with KVCT images.The setup errors of x,y,and z translations and roll rotation were analyzed with the t-test or one-way ANOVA.Meanwhile,PTV margin was calculated based on the formula of M =2.5 Σ + 0.7δ Results According to the formula,the CTV-PTV margins in the x,y and z directions are slightly different between cancers located in the cervical,upper thoracic,middle thoracic,and lower thoracic segments.In patients with upper thoracic esophageal cancer,the average setnp error in the yaxis was lower when the head-neck-shoulder thermoplastic film fixation was used than when somatic thermoplastic film fixation (P=0.000);the setup errors of z-axis with somatic thermoplastic film fixation in the fifth and sixth weeks were slightly less than those in the first several weeks (P =0.036);the setup errors acquired by three image registration patterns were similar (x-axis P=0.868,y-axis P=0.491,z-axis P=0.169,roll P=0.985).Conclusions In the treatment of patients with esophageal cancer,the setup errors are large,but the MVCT in the TOMO HD system can greatly reduce the setup errors,ensuring the accuracy of each treatment.It is further recommended that in clinical practice,different CTV-PTV margins should be used for the treatments of esophageal cancers located in different segments.Patients with upper thoracic esophageal cancer are advised to use the head-neck-shoulder thermoplastic film fixation.