Objective To assess the technical levels of computed tomography (CT) quality control testing capabilities among radiological health technology service institutions in Hubei Province, China. Methods Ten radiological health technology service institutions in Hubei Province were organized to participate in an inter-institutional capability comparison of selected indicators in CT quality control testing with reference to the Specification for testing of quality control in X-ray computed tomography (WS 519—2019). The robust Z-score method was employed to evaluate the results of the capability comparison data from the ten institutions. Results Six institutions achieved a "satisfactory" rating in all assessed indicators, with a satisfaction rate of 60%. Indicators rated as "unsatisfactory" or "questionable" included "positioning light accuracy", "uniformity", "noise", and "high-contrast resolution". Conclusion The CT quality control testing capabilities of some radiological health technology service institutions in Hubei Province require further enhancement. Improved training and education for testing personnel are recommended.

Objective To assess the clinical significance of extra-adipose capsule route and intra-adipose capsule route for the resection of benign adrenal tumors with retroperitoneal laparoscopic adrenalectomy(RLA),and to explore the selection of route based on the mayo adhesive probability(MAP)scoring system.Methods Clinical data of 102 patients who received RLA and pathologically diagnosed as benign adrenal tumors during Feb.2015 and Dec.2020 in the First Affiliated Hospital of Xi'an Jiaotong University were retrospectively reviewed,and MAP scores were assessed with the preoperative tomography images.The gross and MAP score stratified perioperative outcomes between extra-adipose capsule route(classical group,n=56)and intra-adipose capsule route(modified group,n=46)were compared respectively.Results All procedures were successfully completed with no conversion to open surgery and with no need for transfusion.There were no significant differences in operation time[(102.1±26.3)min vs.(110.2±32.1)min,P=0.17]and intraoperative blood loss[(53.5±34.0)mL vs.(61.1±48.4)mL,P=0.35]between the two groups.Subgroup analysis based on MAP score showed that for low risk patients(MAP score 0-2),operative results were comparable between the two groups,but for high risk patients(MAP score 3-5),the operation time was significantly shorter[(114.7±20.7)min vs.(137.2±23.0)min,P＜0.01],and blood loss was significantly less[(52.7±33.1)mL vs.(92.8±49.7)mL,P=0.01]in the classical group than in the modified group.Conclusion RLA could be performed with either surgical routes safely and effectively.MAP scoring system could be an effective tool for preoperative surgical route planning.Compared with the modified route,classical route is more suitable for patients with high MAP score to achieve better operative outcomes.

Objective:To evaluate the efficacy of new arch-clamping technique in Sun’s procedure to repair acute type A aortic dissection.Methods:67 consecutive patients with acute type A aortic dissection who underwent total arch replacement and frozen elephant trunk implantation(TAR+ FET) from Dec 2019 to Dec 2022 with using new arch-clamping technique during operation. Relative intraoperative and postoperative variables and complications were compared.Results:Cardiopulmonary bypass time was(166.66±32.81)min, the aortic occlusion time was(100.49±19.96)min, the circulatory arrest time was(3.97±1.63)min, the lowest nasopharyngeal temperature was(25.716±1.304)℃, and the lowest bladder temperature was(26.209±1.552)℃. The whole group died in hospital in 2 cases(2.98%), cerebral infarction in 3 cases(4.48%), transient neurological dysfunction in 4 cases(5.97%), paraplegia patients in 1 case(1.49%), renal failure requiring continuous dialysis in 4 cases(5.97%).Conclusion:New arch-clamping technique decrease postoperative complication, and is a safe and feasible innovative approach to effectively improve surgical outcome of Sun’s procedure for repair of acute type A aortic dissection.

Objective:To evaluate the safety and efficacy of the neoadventitia technique for root repair in acute type A aortic dissection(ATAAD).Methods:From January 2019 to February 2022, a total of 94 patients with ATAAD who underwent surgical treatment in Beijing Anzhen Hospital were retrospectively analyzed. According to the different treatment methods for the aortic root, the patients were divided into the neoadventitia technique group(58 cases) and the Bentall group(36 cases). The perioperative data and postoperative follow-up results of the two groups were compared, and the efficacy of the new adventitia technique in acute type A aortic dissection was analyzed.Results:There were no intraoperative deaths. The 30-day mortality was 3.4% and 5.6% in the neoadventitia group and Bentall group, respectively ( P=0.636). The cardiopulmonary bypass time[(154.3±29.8)min, P<0.001] and aortic clamp time[(94.7±20.6)min, P<0.001)]were significantly shorter in the neoadventitia group, compared with the Bentall group. Aortic regurgitation was significantly improved after the operation (0.33±0.50 vs. 1.02±0.80, P<0.001). No aortic root-related secondary intervention occurred during follow-up. There was no significant difference in mortality between the two groups( P=0.248). Conclusion:Neoadventitia root repair is a safe and feasible method for the treatment of ATAAD, which has good short-term and mid-term efficacy.

Aortic aneurysm (AA) is a vascular disease involving the progressive dilation of aorta diameter. It is usually asymptomatic but with high mortality once rupture. Currently, there is no effective pharmacologic treatment. MicroRNA specifically refers to non-coding small RNAs consisting of 19-25 nucleotides. The characteristic of microRNA targeting multiple genes seems to form a complicated regulation network, which receives considerable attention. Emerging studies show that microRNAs are closely related to the occurrence and development of AA. Many microRNAs are involved in multiple cell processes and functions and may participate in the pathogenesis of AA, including endothelial cell dysfunction, inflammatory cell infiltration, smooth muscle cell apoptosis, and extracellular matrix degradation. This article will describe the animal models for AA research and the latest progression of microRNA and AA.

Objective To measure the parameters of bronchus and peripheral pulmonary small vessel in the early simple pulmonary contusion, and to explore the changes of bronchial and pulmonary small blood vessels after pulmonary contusion.Methods The chest CT images of 30 patients with early simple pulmonary contusion were collected retrospectively,images were then automatically segmented using FACT-Digital lung TM software.Ipsilateral,contralateral bronchial parameters (luminal cross-sectional area,wall thickness,internal and external diameter,inner and outer circumference and luminal density)and pulmonary small vessel parameters (number of vessels in the visual area,total blood vessel area)for 33 pulmonary contusion cases were measured respectively,finally,correlation between lung contusion area and bronchial and small vessel parameters were analyzed.Results Ipsilateral bronchial parameters (luminal cross-sectional area, wall thickness,internal and external diameter,inner and outer circumference and luminal density)and pulmonary small vessel parameters (number of vessels in the visual area,total blood vessel area)were greater than those in the contralateral(P<0.05).The area of pulmonary contusion was not associated with bronchial parameters nor pulmonary small vessel parameters.Conclusion Quantitative CT analysis can intuitively show the changes of bronchial and pulmonary small blood vessels in patients with early simple pulmonary contusion.

Objective To summarize the clinical outcomes and surgical indications for chronic type A aortic dissection (CTAD) by using Sun's procedure with preservation of autologous brachiocephalic vessels.Methods From September 2010 to December 2013, 23 patients with CTAD underwent Sun's procedure with preservation of autologous brachiocephalic vessels under moderate hypothermic circulatory arrest combined with selective cerebral perfusion in our center .The data was collected and analysed retrospectively.There were 20 males and 3 females patients with a mean age of(49.91 ±10.05) years.Preopera-tive comorbidities included Marfan syndrome in 1 patient, isolated left vertebral artery in 1, hypertension in 19, coronary artery disease in 2, heart dysfunction in 1, renal insufficiency in 1, mitral regurgitation in 1, and pulmonary infection in 1.Previous operation history included thoracic endovascular aortic repair in 3, percutaneous coronary intervention in 1, aortic valve re-placement in 1, Bentall procedure in 1, and coronary artery bypass grafting in 1.Results The average operation time, car-diopulmonary bypass time, aortic cross clamping time and selective cerebral perfusion time was(6.43 ±1.03) h,(167.07 ± 49.62) min,(80.74 ±29.00) min, and(27.35 ±6.03) min, respectively.Concomitant procedures included Bentall proce-dure in 6 patients, ascending aorta replacement in 17, ascending aorta-femoral artery bypass in 1, mitral valvuloplasty in 1, and CABG in 1.There were 2(8.70%) in hospital deaths.Three patients suffered temporary renal dysfunction, and 1 with re-nal failure recieved continuous renal replacement therapy .Postoperative hypoxemia were found in 2 patients, and 1 of them re-ceived reintubation.These patients recovered before discharge.The mean follow-up time was(52.52 ±9.89) months with a follow-up rate of 95.23%(20/21).One patient suffered cerebral embolism but recovered soon after treatment.The others were free from any complications.Conclusion Sun's procedure with preservation of autologous brachiocephalic vessels simplified the aortic arch surgery and obtained satisfactory outcomes for suitable patients with CTAD , but surgical indications should be strictly considered.

KylinRay-IMRT is the advanced radiotherapy treatment planning module of accurate radiotherapy system (KylinRay) aiming to provide accurate and efficient plan design platform. In this paper the system design, main functions and key technologies of KylinRay-IMRT were introduced. KylinRay-IMRT supports three dimensional conformal radiotherapy (3D-CRT), intensity modulated radiotherapy (IMRT) and many other types of treatment plan design with function modules including patient data management, image registration and fusion, image contouring, image three dimensional reconstruction and visualization, three dimensional conformal radiotherapy planning, intensity modulated radiotherapy planning, plan evaluation and comparison, and report print. KylinRay-IMRT has been tested by the national standard YY/T 0889-2013, the results showed that the performance of KylinRay-IMRT can fully meet the standard requirements.
Humans ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy, Conformal ; Radiotherapy, Intensity-Modulated ; Tomography, X-Ray Computed

Objective To summarize the clinical results of the surgical treatment for Stanford B aortic dissection patients with proximal aortic aneurysm(including aortic root,ascending,arch) by enblock technique.Methods From Jun.2011 to Oct.2015,20 patients with Stanford type B aortic dissection and proximal aortic aneurysm underwent open surgery by enbloc technique in our center.Among them,there were 15 male and 5 female.Average age of patients was(40.65 ± 13.55) years (range:22-65 years).The comorbidities of proximal aortic diseases are ascending aortic aneurysm in 10,aortic root aneurysm in 8,and aortic arch aneurysm in 2.All the surgeries were accomplished by hypothermic cardiopulmonary bypass assist.The combined surgery includes:extra-anatomy bypass grafting in 16,Bentall procedure in 15,ascending aortic repair in 5.Before surgery and discharged from hospital computed tomography angiography(CTA) was performed in each patient.All patients except 2 were followed.During the follow-up,CTA was performed and recorded.Results The average operation time,cardiopulmonary bypass time,aortic clamping time and selective cerebral perfusion (SCP) time are (6.47 ± 1.01)h (4.5-9 h),(173.60 ± 43.39) min (109-303 min),(91.25 ± 28.63) min (51-165 min),(27.25 ± 6.80) min (17-43 min),respectively.The mean nasopharyngeal temperature during SCP is(23.77 ± 1.27)℃ (21.6-26℃).There were no operative deaths.The mean follow-up time is (32.44 ± 17.27)months (range:8-60 months).Two patients underwent aortic re-intervention during follow-up.And 2 patients were lost follow-up(The follow-up rate is 90％).One late death was found.The patient succumbed to sudden distal aortic rupture.Other patients are survived without any complications.Conclusion Enblock technique is a relatively simple procedure in total aortic arch repair surgery.And it can be a safely surgical treatment for type B aortic dissection patients with proximal aortic aneurysm.The indications of enblock technique for Stanford B aortic dissection patients are those who combined with proximal aortic aneurysm.

Objective To estimate the incidence of drop out of treatment in patients with access to methadone maintenance treatment and explore the correlation and interaction between insufficient methadone dosage and morphine positive urine on the drop out in Guangxi Zhuang Autonomous Region.Methods Face to face interview was conducted in 1 031 patients at 3 methadone maintenance treatment clinics in Guangxi.Results The study included 1 031 participants,40.6％ of them (419/1 031) had stopped treatment.The drop out rates in urine morphine positive group and methadone dosage ＜ 100 mg/d group were 57.6％ (99/172) and 37.4％ (347/929) respectively,higher than those in urine morphine negative group and methadone dosage ≥ 100 mg/d group (42.3％,363/ 859,and 26.5％,27/102).Orderly logistic regression analysis results showed that after adjusted factors,such as gender,age,marital status,ethnic group,patients who received a dosage less than 1 00 mg/day (OR=3.05,95％CI:1.84-5.06) and had morphine positive urine (OR=2.25,95％CI:1.59-3.19) were more likely to drop out of the treatment.Interaction analysis showed that dosage less than 100 mg/d and morphine positive urine during treatment had additive interaction (RERI=256.46,AP=0.87,S=8.05) and multiplication interaction (OR=2.45,95％CI:1.71-3.49).Conclusion Insufficient dosage and morphine positive urine were significantly correlated with drop out of treatment in patients with access to methadone maintenance treatment.