Objective:To study the changing characteristics and impact factors of helical tomotherapy (HT)for longitudinal dose fall-off outside the target, in order to guide the plan junction or pretreatment target and implementation efficiency in clinical.Methods:Eight patients with head and neck tumors admitted to the Department of Oncology Radiotherapy of the First Affiliated Hospital of Zhengzhou University in December 2019 were retrospectively selected as the research objects. The planning target area and dose drop structure were outlined in the head and neck images with a thickness of 1 mm obtained by Siemens SOMATOM Definition AS positioning computerized tomography (CT). Different field widths (FW, 5.0 cm/2.5 cm/1.0 cm) and pitches (0.430/0.287/0.215) were assembled for planning with the same modulation factor (1.8), finest does calculation grid (0.195 cm ×0.195 cm) and other planning parameters were consistent. The plans were designed by different parameters, and the result was analyzed by univariate analysis.Results:The that different pitch curves coincided under the same field width by comparative analyzing, so pitchs had no effect on dose drop. The different field width curves were independent of each other, indicating that the field width had an effect on dose drop in the head and foot direction. The relationship between the longitudinal dose drop speed outside the target and the change of the field width was inversely correlated: the larger field widths meant the slower dose fall-off and the larger penumbra, while the smaller field widths meant the faster fall-off and the smaller penumbra. When the dose fall-off to 50% of the prescribed dose, the distance from the target was approximately equal to half the field widths, and the pitchs had not affect the rate of dose-drop, while the dose at different distances from the target boundary could be calculated by the fitting formulas. The field widths and pitchs had little effect on the CI and HI index of the target, relatively, the target area was best when the field width was 2.5 cm. The total beam-on time gradually decreased with the increase of the field widths and pitches.Conclusions:When segment target therapy needs to consider planning junction, execution efficiency, and controlling longitudinal dose fall-off and considered the execution, the optimal planned parameters such as field widths and pitches could be selected or the target at the junction regions could be adducted according to the longitudinal dose drop formula, so as to achieve the ideal dose distribution.

Objective:To evaluate the combined effect of an trajectory log field based(LBF)and two commercial dose reconstruction systems on volume-modulated arc therapy(VMAT)dose verification of lung cancer.Methods:An in-house program was developed to introduce errors in trajectory log of TrueBeam to the origin plan and recalculate the dose of the error plan in treatment planning system(TPS). A total of 18 lung cancer cases treated by two-arc VMAT were selected to perform on LINAC and measured by ArcCheck simultaneously. Then, the reconstructed doses were obtained by 3DVH. The mode of reconstruction was calculated by LFB and Compass. Five of the 18 cases were performed on LINAC two times in four hours and measured by ArcCheck to evaluate the stability of the TrueBeam performance. The 18 plans were recalculated and performed on LINAC with a solid water phantom with 5 cm build-up, 4 cm back scattering thickness and a FC65-G detector in the center. The measured dose by detector was compared with the reconstructed dose by three systems.Results:TheTruebeam performance was stable. For all of the 18 cases, the point dose measured by FC65-G and reconstructed by three systems had a deviation of less than 2% to the TPS calculated. For all of the organs reconstructed by LBF and most organs reconstructed by 3DVH and Compass, the γ pass rate between them and TPS all exceeded 90% under all criteria, as well as the ArcCheck measured results. For all the organ dose difference between reconstructed and TPS, LBF system had the smallest difference, followed by the Compass system except the lung, and the 3DVH had the highest difference.Conclusions:LBF, 3DVH and Compass can reflect the VMAT dose verification results of lung cancer from different perspectives. The combined application of three systems can demonstrate the verification results in an intuitive manner, which is beneficial for subsequent analysis.

Objective To investigate the optimal distance between upper and lower target volumes and their correlated planning parameters by analyzing the dose distribution in the abutment regions during total body irradiation ( TBI) using helical tomotherapy. Methods A total of 10 patients with acute leukemia and with a height around 120 cm were enrolled. All patients were scanned by a Siemens simulation computerized tomography (CT) at a slice thickness of 5 mm. A lead wire was placed 10. 0 cm above the patella as a marker of the separation boundary for the upper and lower target volumes. The delineations of target volumes and organs at risk ( OARs ) were performed in the Varian Eclipse 13. 5 workstation with targets shrunk beyond the separation boundary at different distances. After contours and CT images were transferred to HT workstation, treatment plans were designed with different field width (FW, 5. 0 cm/2. 5 cm/1. 0 cm) and pitch values (0. 430/0. 287) at a modulation factor of 1. 8. All the plans were optimized with a dose calculation grid of 0. 195 cm × 0. 195 cm and identical planning parameters. The correlation between treatment planning parameters and targets shrunk distances were investigated by analyzing the dose distributions in the abutment area. Results The study demonstrated that the dose distributions in the abutment area were influenced only by the field width parameters: when the gap distance between the upper and lower targets was 5. 0 cm, the optimal FW is 5. 0 cm;Similarly when the gap distances were 2. 0 cm and 1. 0 cm, and the optimal FW 2. 5 cm and 1. 0 cm, respectively. In another words, the dose distribution of the abutment region was optimal when the target gap distance was equal to FW. Pitch values did not affect the quality of dose distribution in the abutment region and the overall treatment time ratio. Overall treatment time was inversely related to the FW. Conclusions Consistent target distance and FW is helpful to improve the dose homogeneity in the abutment area during TBI with HT. Appropriate planning parameters is critical to balance the treatment efficacy and efficiency.

Objective To observe the clinical efficacy of the combination of western medicine with acupuncture for treatment of polycystic ovary syndrome (PCOS) of infertility.Methods Totally 120 PCOS patients were randomly divided into western medicine group and acupuncture group, 60 cases in each group. All patients took Diane-35, and with whom resistant to insulin were added with Metformin. At the meantime patients increased the amount of exercise with adjustment and control of everyday diet. After three periods, the western medicine group used the method of Clomifene Citrate with Chorionic Gonadotropin to help ovulation induction. The acupuncture group used the method of acupoint selection including invigorating spleen and kidney with adjusting qi and blood to promote ovulation. The level of FSH, LH, FINS, E2 and T of the two groups were observed before and after treatment.Results After treatment, the levels of T, FINS, LH and BMI in the two groups decreased, with statistical significance (P<0.05). The levels of T and BMI in the acupuncture group were lower than the western medicine group after the treatment, with statistical significance (P<0.05). The total efficiency, gestation number, number of high-quality follicle, and basal body temperature of acupuncture group were all higher than the western medicine group, with statistical significance (P<0.05).Conclusion The combination of western medicine with acupuncture for treatment of PCOS of infertility has confirmed efficacy.

Objective To establish a quick electrochemical biosensor for the detection of nucleic acid of Ebola virus . Methods The DNA tetrahedral nanostructure was self-assembled on gold surface by strong Au-S chemical bonds , leaving the target probe at the top .A biotinylated-ssDNA was introduced as the detection probe by specific binding of the captured target sequence , before avidin-horseradish peroxidase ( HRP) was used as a signal amplifier to transduce amperometric sig-nal through interactions with TMB substrate .Results The results indicated that the nucleotide sequence of Ebola virus could be recognized and detected by the sensor .The linear range for the detection of target DNA was from 1.0 ×10 -9 to 5.0 ×10 -6 mol/L,and the detection limit was 5.2 ×10 -10 mol/L.Conclusion The fabricated sensor is demonstrated to be sensitive and specific for the detection of Ebola virus nucleotide .

Objective To explore the relationship between Stathmin-1 and human papilloma viruse (HPV) persistent infection after conization of uterine cervix, and to show the clinical significance to recurrent of cervical intraepithelial neoplasia (CIN). Methods One hundred and six patients who were treated with conization of uterine cervix for CIN 2-3 grades were enrolled. Thirty-six recurrent patients were enrolled in recurrence group, and the others were enrolled in control group. The expression of Stathmin-1 in primary CIN tissues in two groups was detected by immunohistochemistry. The HPV infection was detected by HPV-DNA test. The relationship of HPV persistent infection and recurrence was analyzed. Results The positive expression rate of HPV persistent infection and HPV persistent infection rate in recurrence group were 88.89%(32/36), 83.33%(30/36), in control group were 34.29%(24/70) and 22.86%(16/70), and there were significant difference (P <0.01). Forty-two patients had HPV persistent infection in 56 patients with stathmin-1 positive expression, and 4 patients had HPV persistent infection in 46 patients Stathmin-1 negative expression. There was positive correlation (r=0.97, P<0.01). The type of HPV persistent infection in two groups was no significant difference (P >0.05). Conclusions Stathmin-1 positive expression is related to HPV persistent infection. The two factors can affect the prognosis of high-grade CIN, and can provide new cues and theory basis for the prevention of recurrence.

Objective To detect the expression of miRNA -34a in normal cervical,low grade cervical intra-epithelial neoplasia and high grade cervical intraepithelial neoplasia,to explore its clinical significance.Methods The expression levels of miRNA -34a in 82 cases of low grade cervical intraepithelial neoplasia (CINⅠ,CIN L group),87 cases of high grade cervical intraepithelial neoplasia (CINⅡ -Ⅲ,CIN H group) and 60 cases of normal cervical tissues (control group) in tissue specimens and serum were examined by real -time PCR(RT -PCR). Results The relative expression levels of miRNA -34a in tissues and serum of CIN H group were (0.584 ± 0.288),(0.528 ±0.299),which of CIN L group were (0.903 ±0.252),(0.847 ±0.279),which of the control group were (0.960 ±0.212),(0.908 ±0.223).The miRNA -34a level of CIN H group in tissues and serum were lower than CIN L group and control group,there was significant difference( Ptissues =0.001,Pserum =0.003).The miRNA -34a level in tissue and serum had no significant difference between the CINL group and control group(P >0.05).The expression level of serum miRNA -34a was positively related with the level of the tissues(r =0.907,P <0.01).Conclusion The expression level of miRNA -34a in high grade CIN was significantly decreased,which indi-cated that miRNA -34a play an important role in the prognosis of CIN and the transformation of cervical cancer,and it has certain clinical value for the diagnosis and treatment of CIN.

Objective To investigate the current status of conventionai diagnostic/therapeutic gastrointestinal (GI) endoscopy (conventional gastroscopy/colonoscopy and endoscopic polypectomy,et al.) in mainland China.Methods The survey was conducted by a questionnaire sent via e-mail or telephone to the hospital-based GI endoscopy units,including three levels of hospitals (Third-Grade Hospital Classification in China).Results From May 2010 to November 2010,169/279 (60.6％)units were enrolled,which covered 28 provinces (90.3％) in mainland China.Among the 169hospitals,147(87.0％ ) hospitals performed GI endoscopy,and all the hospitals performed gastroscopy (100％).Furthermore,100％ of the tertiary hospitals,and 93.9％ (138/147) of the second-level hospitals performed colonoscopy,significantly higher than that of the first-level hospitals (25.0％)(x2 =60.9,P＜0.01).All the tertiary hospitals (100％),and 79.8％ (71/89) of the second-level hospitals perform endoscopic polypectomy,significantly higher than that of the first-level hospitals (16.7％,x2 =20.0,P＜0.01,P＜0.05).Among the 147 hospitals with the ability to perform GI endoscopy,74 hospitals (50.3％) performed endoscopic retrograde cholangiopancreatography (ERCP).Furthermore,76.1％ (35/46) of the tertiary hospitals performed ERCP,significantly higher than that of the second-level hospitals (43.8 ％,39/89) (x2 =12.7,P＜0.01),and none of the 12 first-level hospitals performed ERCP,endoscopic ultrosonography (EUS) or EVL/EVS(endoscopic oesophageal varices ligation/sclerotherapy).Conclusions The conventional diagnostic GI endoscopy (routine gastroscopy and colonoscopy) was popularized in the tertiary and the second-level hospitals,and there was still much to improve for the first-level hospitals.With regard to the conventional therapeutic endoscopics,ERCP and EVL/EVS were more popular in the tertiary hospitals,while the second-level hospitals have much to improve.

ObjectiveTo investigate the popularity of the sedated gastrointestinal endoscopy in mainland China.MethodsThe survey on the popularity of the sedated gastrointestinal endoscopy was conducted with questionnaires sent by e-mails or telephones to the GI endoscopy units of three levels of hospitals.ResultsFrom May,2010 to November,2010,169 units from 28 provinces (90.3％ ) were enrolled,including 46 hospitals of grade Ⅲ,91 of grade Ⅱ and 32 of grade Ⅰ.Sedated gastrointestinal endoscopy were performed in 110 (65.1％,110/169) hospitals,i.e.93.5％ (43/46) grade Ⅲ hospitals,68.1％(62/91) grade Ⅱ hospitals and 15.6％ (5/32) grade Ⅰ hospitals.Significant difference was observed between the grade Ⅲ and the grade Ⅱ hospitals (P ＜ 0.05 ),so was between the grade Ⅱ and the grade Ⅰ hospitals ( P ＜ 0.05 ).Propofol was frequently used in sedation in 98 hospitals ( 89.1％ ).The only 9.1％( 10/110)hospitals,which had full-time anesthetists or anesthetic nurses,were all grade Ⅲ hospitals.ConclusionThere has been great progress in the popularity of sedated gastrointestinal endoscopy in mainland China during the past decade.However,it is less frequently pefformed in grade Ⅰ and Ⅱ hospitals.Shortage of full-time anesthetists is still a problem.

Objective To evaluate the feaibility and safety of gastrotomy in natural orifice transluminal endoscopic surgery(NOTES)using technique of percutaneous endoscopic gastostomy(PEG).Methods To retrospectively investigate and compare the success rate,complications and procedure time of gastrotomy in NOTES of dogs between PEG-like approach(PEG group,n =20)and needle knife incision(needle knife group,n =18).Results Gastrotomy was successfully performed in all animals.No mass bleeding or organ injury was observed in PEG group,while one dog in needle knife group encountered mass bleeding,and injuries to the adjacent organs were found in 3 others(0％ in PEG group vs.22％ in needle knife group,P ＜ 0.05).The procedure time of gastrotomy in PEG group was longer than that of needle knife group (15.0±3.7 min vs.6.0 ± 1.1 min,P ＜0.05).Conclusion Compared with the techniqued of needle knife incision,gastrotomy using PEG-like approach in NOTES is safe and feasible.