The proton treatment control system is the supporting software of the proton therapy device, which specifically coordinates and controls the status and work of each subsystem. In this study, the software architecture and hardware implementation of the proton treatment control system was developed and built a foundation for the overall debugging. Using C# programming language and WPF programming techniques, TCP network communication protocol specified by the proton treatment technical document and MVVM pattern in Windows system, the logic design and implementation of each level were studied. Meanwhile, the communication interface between the subsystems under TCP communication protocol was agreed. The logic design and research of the setup field and treatment field were carried out. And the User Interface was designed and developed using the above technology. The program realizes the communication and interaction between the proton treatment control system and each subsystem, so as to control and monitor the whole treatment process. The proton treatment control system provides a software basis for the remote overall debugging and on-line monitor and control of proton treatment device.
Protons ; User-Computer Interface ; Software ; Computers ; Logic

Objective:To evaluate the long-term efficacy of laparoscopic-assisted natural orifice specimen extraction surgery (NOSES) colectomy using Cai tube for treating left-sided colorectal cancer.Methods:This was a randomized controlled trial. Inclusion criteria were as follows: preoperative pathological diagnosis of left-sided colorectal adenocarcinoma (rectal, sigmoid colon, descending colon, or left transverse colon cancer with the caudad margin ≥8 cm from the anal margin); preoperative abdominal and pelvic computed tomography (or magnetic resonance imaging) showing maximum tumor diameter <4.5 cm; and BMI <30 kg/m 2. Patients with synchronous multiple primary cancers or recurrent cancers, a history of neoadjuvant chemoradiotherapy, preoperative evidence of significant local infiltration, distant metastasis, or complications such as intestinal obstruction and intestinal perforation, or who were not otherwise considered suitable for laparoscopic surgery were excluded. A random number table was used to randomize sequential patients to NOSES surgery using Cai tube (non-assisted incision anal sleeve: patent number ZL201410168748.2) (NOSES group) or traditional laparoscopic-assisted surgery (CLS group). Relevant clinical data of the two groups of patients were analyzed, the main outcomes being disease-free survival, overall survival, overall recurrence rate, and local recurrence rate 5 years after surgery. Results:Patients in both study groups completed the surgery successfully with no requirement for additional surgery. After mean 70 (7–83) months postoperative follow-up, the 5-year overall postoperative survival in the NOSES and CLS groups was 90.0% and 83.3%, respectively ( P=0.455); disease free survival was 90.0% and 83.3%, respectively ( P=0.455); overall recurrence rate 6.6% and 10.0%, respectively ( P=0.625); and local recurrence rate both were 3.3% ( P=0.990), respectively. None of these differences was statistically significant. Conclusions:NOSES and CLS have similar long-term efficacy, and NOSES deserves to be used in clinical practice.

Objective:To evaluate the long-term efficacy of laparoscopic-assisted natural orifice specimen extraction surgery (NOSES) colectomy using Cai tube for treating left-sided colorectal cancer.Methods:This was a randomized controlled trial. Inclusion criteria were as follows: preoperative pathological diagnosis of left-sided colorectal adenocarcinoma (rectal, sigmoid colon, descending colon, or left transverse colon cancer with the caudad margin ≥8 cm from the anal margin); preoperative abdominal and pelvic computed tomography (or magnetic resonance imaging) showing maximum tumor diameter <4.5 cm; and BMI <30 kg/m 2. Patients with synchronous multiple primary cancers or recurrent cancers, a history of neoadjuvant chemoradiotherapy, preoperative evidence of significant local infiltration, distant metastasis, or complications such as intestinal obstruction and intestinal perforation, or who were not otherwise considered suitable for laparoscopic surgery were excluded. A random number table was used to randomize sequential patients to NOSES surgery using Cai tube (non-assisted incision anal sleeve: patent number ZL201410168748.2) (NOSES group) or traditional laparoscopic-assisted surgery (CLS group). Relevant clinical data of the two groups of patients were analyzed, the main outcomes being disease-free survival, overall survival, overall recurrence rate, and local recurrence rate 5 years after surgery. Results:Patients in both study groups completed the surgery successfully with no requirement for additional surgery. After mean 70 (7–83) months postoperative follow-up, the 5-year overall postoperative survival in the NOSES and CLS groups was 90.0% and 83.3%, respectively ( P=0.455); disease free survival was 90.0% and 83.3%, respectively ( P=0.455); overall recurrence rate 6.6% and 10.0%, respectively ( P=0.625); and local recurrence rate both were 3.3% ( P=0.990), respectively. None of these differences was statistically significant. Conclusions:NOSES and CLS have similar long-term efficacy, and NOSES deserves to be used in clinical practice.

Objective:To explore the effect of modified Simiao Yong'an Decoction combined with conventional western medicine on lower limb hemodynamics in patients with low-risk diabetes foot (DF).Methods:This retrospective cohort study included 70 patients with infectious diabetic foot, between January 2015 and May 2019, and they were divided into control group and study group, with 35 in each group. The control group was treated with conventional western medicine, while the study group was treated with modified Simiao Yong'an Decoction on the basis of the control group. Both groups were treated for 4 weeks and followed up for 1 year. The levels of basic fibroblast growth factor (bFGF) and VEGF were detected by ELISA, the levels of blood viscosity, fibrinogen and HbAlc were detected by automatic hemorheological analyzer, the dorsal artery of foot was detected by color Doppler ultrasound, the diameter and blood flow velocity of dorsal artery of foot were recorded, and the conduction velocity of sural nerve and common peroneal nerve were detected by electromyography for recurrence rate calculation. And the clinical response rates were evaluated.Results:The total clinical response rate was 94.3% (33/35) in the study group and 77.1% (27/35) in the control group, and there was significant difference between the two groups ( χ2=4.20, P=0.040). After treatment, the bFGF [(177.15±7.96)ng/L vs. (158.87±7.21)ng/L, t=10.00], VEGF[(53.77±4.15)ng/L vs. (45.44±4.92)ng/L, t=7.66] levels in the study group were significantly higher than those in the control group ( P<0.01). After treatment, the whole blood viscosity [(3.84±0.86)mPa?s vs. (4.56±0.99)mPa?s, t=3.25], fibrinogen [(3.59±0.78) g/L vs.(4.23±0.97)g/L, t=3.04]and HbAlc[(9.61±1.31)% vs. (10.85±1.82)%, t=3.27] levels in the study group were significantly lower than those in the control group ( P<0.01). After treatment, the sural nerve conduction velocity [(39.42±5.11)m/s vs. (34.22±4.52)m/s, t=4.51], common peroneal nerve conduction velocity [(40.94±4.22)m/s vs. (35.52±3.72)m/s, t=5.70], blood vessel diameter [(2.21±0.60)mm vs. (1.92±0.52)mm, t=2.16], while the blood flow velocity [(55.89±5.84)cm/s vs. (52.95±5.85)cm/s, t=2.10] in the study group were significantly higher than those in the control group ( P<0.05). During the follow-up, the recurrence rate was 21.21% (7/33) in the study group and 29.63% (8/27) in the control group. with out statistical significance between the two groups ( χ2=0.20, P=0.653). Conclusion:Modified Simiao Yong'an Decoction combined with conventional western medicine can improve lower limb blood circulation and nerve conduction velocity of low-risk DF patients, promote rehabilitation and reduce recurrence.

Objective:To explore the potential mechanism of Jiajian Xuezheng Decotion in infiltrative gastric cancer by network pharmacology and proteomics.Methods:The Traditional Chinese Medicine Systems Pharmacology Database (TCMSP) database was used to find the compounds and their targets of Jiajianxuezhengtang, and the targets of invasive gastric cancer were determined by high performance liquid chromatography with tandem mass spectrometry (HPLC-MS/MS). The predicted target gene of Jiajian Xuezheng Decotion and the target protein data of infiltrative gastric cancer were analyzed by Venny to obtain the target gene. The target gene set was analyzed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment by the David. The protein interaction network diagram (PPI) was obtained by the String method, displaying the prescription-drug-compound-gene network in Cytoscape software.Results:69 active ingredients and 215 drug targets were screened from Jiajian Xuezheng Decotion; 660 proteins were significantly up-expressed in infiltrative gastric cancer, and 10 drug targets and gene targets were the common targets. There were 10 protein nodes in the PPI network, of which 3 core nodes were CASP3, BCL2L1 and STAT1. The 11 KEGG pathways were significantly enriched such as include PI3K-Akt signaling pathway, p53 signaling pathway, proteoglycan in cancer, apoptosis, Jak-STAT signaling pathway and other pathways.Conclusions:Jiajian Xuezheng Decotion plays an anti-infiltrative gastric cancer effect possibly regulated apoptosis through PI3K-Akt signaling pathway, p53 signaling pathway and Jak-STAT signaling pathway. This study provides a theoretical basis for further research on the mechanism of Jiajian Xuezheng Decotion in the treatment of invasive gastric cancer.

OBJECTIVETo investigate the feasibility and safety of membrane-based right-sided approach of laparoscopic suprapancreatic lymph node dissection for advanced distal gastric cancer.

METHODSThe clinical data of 41 patients with advanced distal gastric cancer who underwent laparoscopic gastrectomy using membrane-based right-sided approach for laparoscopic suprapancreatic lymph node dissection at the Department of Gastrointestinal Surgery, Zhongshan Hospital of Xiamen University from January 2016 to January 2018 were retrospectively analyzed. There were 24 males and 17 females with a mean age of 56.8 years and a mean body mass index of 22.6 kg/m². Membrane-based right-sided approach of laparoscopic suprapancreatic lymph node dissection contained 4 steps briefly: (1) dissection of mesenteria above the head of pancreas: the tri-junction of pancreas-duodenum was cut to expose and identify the logo of Benz;clearance of the membrane of No.5a was performed towards the left, and then expanded to the posterior layer of No.12a. (2) dissection of the V shape dorsal mesogastrium: membrane bridge at splenic artery trunk root was cut; in suprapancreatic space, clearance was performed towards to the left to the middle of the splenic artery trunk and expanded to the posterior Tolds plane upwards to the posterior phrenic angle and retroperitoneal esophagus, then the surrounding tissue of anterior abdominal aorta. (3) dissection of the U shape mesenteria:membrane bridge at common hepatic artery root was cut; mesentery was separated; the left gastric vein was freed and ligated at its root; in posterior pancreatic space, the mesentery of No.7, No.9 and No.8 was dissected in turns; the left gastric artery was high ligated and cut; the portal vein and posterior dorsal mesogastrium Toldt plane was routinely exposed; clearance was performed to right for No.8a and upward to the hepatic portal meeting at posterior mesentery No.12 plane. (4) dissection of the upper triangular area of pylorus: the trigone mesentery was cut along the upper edge of the pylorus; No.12a was swept upward along the gastric ventral mesentery; the upper boundary(No.8a) on the right side of the U-shaped membrane was joined. Intraoperative and postoperative presentations were analyzed.

RESULTSLaparoscopic gastrectomy for advanced distal gastric cancer with membrane-based right-sided approach of laparoscopic suprapancreatic lymph node dissection was successfully carried out in all the 41 patients. Distal gastric mesenteria en bloc resection was successfully performed. The operation time was (145.2±25.4) minutes and intraoperative blood loss was (53.3±18.3) ml without massive bleeding and severe complication. Number of lymph nodes dissected was 41.1±6.4, and number of suprapancreatic lymph node dissected was 23.3±3.7 without residual cancer at cut margin by pathology. Postoperative drainage volume was (65.8±21.7) ml; time to withdraw of catheter was (7.0±1.7) days; time to fluid intake was (3.5±1.8) days; postoperative hospital stay was (10.4±2.8) days; time to postoperative anal exhaust was (3.3±1.1) days. No complications, such as chyle leakage, postoperative massive bleeding, anastomotic leakage, abdominal cavity infection or gastroplegia occurred within 30 days after surgery.

CONCLUSIONMembrane-based right-sided approach of laparoscopic suprapancreatic lymph node dissection for advanced distal gastric cancer can achieve en bloc resection and conform to the radical principle of oncology, and is safe and feasible.

Objective To calculate precisely and reasonably the manpower needs for outsourcing hospital logistic services. Methods The methods of literature research, observation, sampling survey and interview of key persons were used, to calculate such outsourcing manpower needs as cleaning and deliveries, based on the area to clean hospital-wide, age of cleaners and delivery workload. Results Five standards were identified for manpower deployment to carry out cleaning assignments. It was calculated that the hospital needs 59 more cleaners, adding the total to 273; 19 more deliverymen, adding the total to 153. Conclusions Calculation of such manpower needs should take into account all the factors for the purpose of fine administration.

Objective To compare cable tension band fixation with other 3 fixations in terms of biomechanical stability for tibial avulsion fractures of the anterior cruciate ligament (ACL).Methods Eighty fresh porcine knees were randomized into 4 equal groups (n =20).For each knee,all the soft tissues were removed only to keep the femur-ACL-tibia complex.The knee complexes were used to create fracture models of standard Meyers-Mc Keever type Ⅲ at the ACL attachment region using a swing saw.The fracture fragments in the 4 groups were subjected to fixation respectively with intramedullary lag screws,high-strength suture,tension band wire and cable tension band.All the specimens were subsequently tested on a Material Testing Machine at a load rate of 60 mm/mm.The 4 groups were compared in terms of ultimate failure load,yield load,and fragmental displacement under single-cycle loading and multi-cyclic loadings.Results Cable tension band fixation displayed significantly higher ultimate failure,higher yield load and lower fragmental displacement than all the other 3 fixations (P ＜ 0.05).Conclusion As cable tension band fixation,which is convenient and economical,provides better biomechanical stability than other 3 fixations for tibial avulsion fractures of the ACL,it may allow earlier functional and weight-bearing exercise after operation.

Objective: To observe the effect of compound preparation of milkvetch root and breviscapine (HDs) on the activity of superoxide dismutase (SOD) and lactate dehydrogenase(LDH), the concentration of malondialdehyde (MDA) in blood and brain and memory impairment in Alzheimer's disease rats.Methods: The rats were randomly divided into 5 groups (10 rats /group): the normal control group, Alzheimer's disease (AD) model group induced by AlCl3(5 mg·kg -1·d-1,ig) and D-gal (40 mg·kg-1·d-1,ip), and 3 AD groups respectively treated with different drugs including piracetam (0.15 g·kg-1·d-1,ig), HDs1(1.5 ml·kg-1·d-1,ip) and HDs2 (3 ml·kg-1·d-1,ip).After 90-day treatment, the step-down test was used to detect the learning and memory ability, and SOD and LDH activity and MDA concentration in blood and brain were examined as well.Results: Compared with that in AD model group, the ability of learning and memory was improved, the activity of SOD and LDH increased significantly, the concentration of MDA decreased significantly in blood and brain in HDs treated groups.The differences were statistically significant (P<0.05 or P<0.01), but they were not restored to normal levels.Some indexes of HDs2 group were better than those of piracetam positive control group and HDs1 group (P<0.05 or P<0.01).Conclusion: HDs can effectively reduce MDA concentration, increase SOD and LDH activity in blood and brain, and improve the ability of learning and memory of AD rats.

OBJECTIVETo explore the feasibility of laparoscopic-assisted natural orifice specimen extraction radical left colectomy.

METHODSRetrospective analysis was performed on clinicopathological dada of 15 colorectal patients who were treated by laparoscopic-assisted anal specimen extraction radical left colectomy with self-developed surgical instrument Cai tube between January and September in 2014. Tumor location included descending colon (n=3), the junction of descending colon and sigmoid colon (n=2), the sigmoid colon (n=6) and upper rectum (n=4). Clinical efficacy of patients was observed.

RESULTSThere were no perioperative deaths or postoperative complications, such as anastomotic bleeding or leakage. The median operation time was 257 (range 103-337) min, median blood loss was 50(range 20-200) ml, median time to first flatus was 3 (range 1-5) d and median hospital stay was 14 (range 11-21) d. All the patients had good quality of life and normal defecation function without tumor recurrence or metastasis after 1-8 months of follow-up.

CONCLUSIONLaparoscopic-assisted anal specimen extraction radical left colectomy is safe and feasible.

Colectomy ; Colon, Sigmoid ; Humans ; Laparoscopy ; Length of Stay ; Operative Time ; Postoperative Complications ; Quality of Life ; Rectum ; Retrospective Studies