Objective:To investigate the feasibility of applying the ArcherQA three-dimensional (3D) dosimetric verification system in intensity-modulated radiotherapy (IMRT) plans for nasopharyngeal carcinoma (NPC).Methods:A retrospective analysis was conducted for 105 NPC patients′ IMRT plans developed using the Eclipse treatment planning system (TPS). Dose verification was conducted using the ArcherQA system and through portal dosimetry (PD). Moreover, this study compared γ passing rates (criteria: 3 mm/3%, TH = 10%) between ArcherQA and PD and the doses delivered to the target volume ( Dmean, D90%) and organs at risk (OARs) ( Dmean) between ArcherQA and TPS, and analyzed the 3D γ passing rates of each organ at risk calculated by ArcherQA. Results:The average 3D γ passing rate calculated by ArcherQA was (99.04±1.01)%, and the average 2D γ passing rate measured by PD was (99.49±0.78)%, with statistically significant differences ( t=-3.35, P< 0.05). The dosimetric differences to the target volume between ArcherQA and TPS were as follows: the average difference in Dmean to the gross tumor volume (GTV) was (0.57±0.48)%, and the average difference in D90% was (0.65±0.56)%. For the target volume, the average γ passing rate was (97.67±3.43)% for GTV, (97.80±4.35)% for GTVnd-L, (97.82±4.07)% for GTVnd-R, (97.88±2.44)% for CTV1, and (96.64±4.32)% for CTV2. The mean dose difference of each target volume was CTV1 (0.57±0.46)%, GTVnd-L (0.85±0.55)%, GTVnd-R (0.73±0.55)%, and CTV2 (0.88±0.52)%. For OARs, the mean γ passing rate was (99.93±0.22)% for the brainstem, (99.17±2.82)% for the optic chiasm, (100±0)% for the lens, (99.56±1.05)% for the spinal cord, (99.00±2.06)% for the thyroid, and (87.86±10.42)% for the trachea. Statistically significant differences in the average doses to OARs were observed ( t=-14.62 to 4.82, P<0.05), except for those to the left optic nerve, the right hippocampus, and the right parotid gland. Conclusions:Based on the high-performance GPU platform and the Monte Carlo dose algorithm, ArcherQA can provide accurate 3D dose distribution and 3D γ passing rates inside patients according to CT images and provide the dose volume histogram (DVH) of various regions of interest (ROIs). Therefore, the ArcherQA three-dimensional dose verification system can be applied to IMRT plans for NPC. Moreover, it is inducive to improve the treatment efficiency since it does not occupy the accelerator operation time.

Objective:To explore the independent prognostic factors of primary osteosarcoma patients under 20 years old after radical surgery, so as to predict the prognosis and survival of patients.Methods:The clinicopathological data of 1 339 patients with primary osteosarcoma diagnosed and registered in the National Cancer Institute Surveillance, epidemiology and outcome database (SEER) from 1984 to 2014 were retrospectively analyzed. Kaplan Meier method was used to calculate the survival rate of patients. Log rank test was used to evaluate the survival difference. Cox multivariate analysis was used to determine the independent prognostic factors of osteosarcoma after radical surgery factor.Results:The results of primary osteosarcoma patients undergoing radical surgery found that 34 cases (2.54%) aged 0-5 years old, 236 cases (17.63%) aged 6-10 years old, and 600 cases (44.81%) aged 11-15 years old and 469 cases (35.02%) aged 16-20 years old. The median survival time was 68 months. Among them, 757(56.53%) were male and 582(43.47%) were female. Among the 1 339 cases, 986 were white (73.64%), followed by black 230(17.18%), and 123 other races (9.18%). Multivariate analysis revealed that males ( HR=1.242; 95% CI:1.024-1.505), axial osteosarcoma ( HR=1.589; 95% CI:1.179-2.166), and regional invasion of osteosarcoma ( HR=1.470; 95% CI:1.156-1.870), distant metastasis ( HR=3.536; 95% CI:2.725-4.589) were independent risk factors for overall survival. Other types of osteosarcoma ( HR=0.471; 95% CI:0.285-0.779) were independent protective factors for overall survival. Conclusions:Based on the SEER database, this study identified independent prognostic factors for patients with primary osteosarcoma under the age of 20 who underwent radical surgery, which will help clinicians formulate individualized medical strategies and predict patients′ prognosis.

Objective:To investigate the impacts of electron streaming effect (ESE) on out-of-field dose distribution in 1.5 T MRI-guided radiotherapy.Methods:Firstly, the Monaco v5.40.1 (Elekta AB, Stockholm, Sweden) treatment planning system (TPS) was implemented to investigate the ESE in a square field (5 cm × 5 cm) at the entry and exit sides of a special homogeneous water phantom. Afterward, a retrospective investigation was conducted into one laryngeal cancer case and one breast cancer case who had been treated on a conventional linear particle accelerator (linac). Then doses were recalculated in the Monaco system using a Unity machine model. Meanwhile, the out-of-field skin dose enhancement induced by ESE was investigated.Results:ESE-induced dose variations were observed at both the entry and exit sides of the phantom surface in the presence of a magnetic field, with the ESE on the exit side notably stronger than that on the entry side. For the laryngeal cancer case, the ESE was not notable and had insignificant impacts on the out-of-field skin dose. In contrast, ESE-induced in-air high-dose region outside the body stretched to the chin area for the breast cancer case. This led to the skin dose escalation of the chin at D1 cm 3 454.6 cGy. After the application of 1 cm bolus, the corresponding skin dose of the chin D1 cm 3 reduced to as low as 113.6 cGy, which is almost equivalent to that in the absence of a magnetic field ( D1 cm 3=92.5 cGy). Conclusions:The ESE in a magnetic field can alter out-of-field dose and lead to local dose enhancement along the electron path. Although the ESE had insignificant impacts on the out-of-field dose of the laryngeal cancer case, it reached the chin area of the breast cancer case. ESE can be effectively shielded by adding protective bolus.

OBJECTIVE：To investigate the effects of Biyuanshu （BYS）oral solution on IFN-γ of chronic rhinosinusitis （CRS）model mice ，and to investigate its potential mechanism on the basis of B 7-H1/PD-1 immune checkpoint. METHODS ：Male C57 mice were randomly divided into normal group ，sham operation group ，chemical medicine control group （clarithromycin，103 mg/kg），BYS low-dose ，medium-dose and high-dose groups （BYS oral solution ，3.1，6.2，12.4 mL/kg），with 20 mice in each group. Except for normal group without any treatment ，other mice were all open maxillary sinus ，sham operation group was not filled with sponge with bacteria ，while model group and administration groups were filled with sponge with bacteria to induce CRS model. Since 8th week after modeling ，normal group ，sham operation group and model group were given normal saline 0.2 mL intragastrically，administration groups were given relevant medicine intragastrically ，once a day ，for consecutive 14 d. The nasal symptoms and general condition of mice were observed ，and the pathological changes of mice ’s nasal sinus mucosa were observed by HE staining ；qRT-PCR was used to measure the mRNA expression of IFN-γ，B7-H1 and PD- 1 in nasal sinus mucosa of mice. RESULTS：The normal group and sham operation group had no abnormal in nose ，and the epithelium and cilia of the nasal sinus mucosa were intact ；there was no significant difference f8y3j0127@163.com in the relative mRNA expression of IFN-γ，B7-H1 and PD- 1 between 2 groups（P＞0.05）. In model group ，the mice were found to have runny n ose，frequent scratching and sneezing ，a small amount of yellow secretion in the nasal cavity ，and serious depilation ；the nasal sinus mucosa was seriously damaged ，cilia was exfoliated ，and the gland in the submucosa was hyperplasia ，lymphocyte infiltration was also found ；the relative mRNA expression of IFN-γ，B7-H1 and PD- 1 were significantly increased compared with normal group （P＜0.01）. Compared with model group，the nasal symptoms ，general condition and pathological changes of the nasal sinuses in each administration group were improved in varying degrees ；the relative mRNA expression of IFN-γ and B7-H1 in chemical medicine control group ，BYS medium-dose and high-dose groups ，as well as the relative mRNA expression of PD- 1 in administration groups were decreased significantly；above indexes of BYS medium-dose and high-dose groups were significantly lower than BYS low-dose group ，while relative mRNA expression of IFN-γ in BYS high-dose group were significantly higher than BYS medium-dose group. The relative mRNA expression of IFN-γ in BYS low-dose and medium-dose groups，the relative mRNA expression of B 7-H1 in BYS low-dose group，the relative mRNA expression of PD- 1 in BYS groups were significantly higher than chemical medicine control group ； mRNA expression of IFN-γ in BYS high-dose group was significantly higher than chemical medicine control group（P＜0.05 or P＜ 0.01）. Above indexes of BYS medium-dose group were similar to those of chemical medicine control group （P＞0.05）. CONCLUSIONS：BYS oral solution can improve chronic inflammation in nasal sinus mucosa of mice ，the mechanism of which may be associated with intervening mRNA overexpression of B 7-H1/PD-1 by inhibiting mRNA expression of IFN-γ.

10.3969/j.issn.2095-4344.2013.24.004

ObjectiveTo compare the therapeutic effec between sustained low-efficiency dialysis (SLED) and continuous blood purification (CBP) in critically ill patients.MethodsAccording to the treatment ways,96 critically ill patients were divided into SLED group and CBP group.A comparison was made on the biochemical indicators,in-hospital duration,hemodynamic parameters,acute physiology and chronic health evaluation (APACHE-Ⅱ ),the survival and the mortality rates.ResultsAfter treatment,the levels of serum creatine kinase isozyme MB (CK-MB),creatine kinase (CK),creatinine (Cr),glutamic-oxalacetic transaminase (AST),glutamate-pyruvate transaminase (ALT),APACHE Ⅱ score on the 1st,2nd and 7th day were lower than those prior to the treatment in both groups ( P ＜0.05).There were no statistical differences in in-hospital duration, biochemical indicators, APACHEⅡscore,hemodynamic parameters,the survival rate and the mortality rate between the two groups (P ＞ 0.05 ).ConclusionsSLED has similar hemodynamic stability with CBP,and the two methods have similar treatment effects in critically ill patients.However,SLED can be relatively economical and convenient for critically ill patients in clinical.

Objective To explore the effect of multiple low dose radiation(LDR)on the apoptosis of splenocytes and immune factors in diabetes mellitus(DM)rats.Methods The rats were randomly divided into control,DM and DM + LDR groups.The irradiation doses were 25,50 and 75 mGy,and the irradiated times were 15.At the fourth weekend after the DM rats irradiated,the apoptotie rate and TCRαβ percentage of splenoeytes were detected by flow cytometry,and the content of IL-2 in both serum and supernatant of cultured splenocytes were detected by ELISA.Results Compared with that in the control,the body weight(BW)decreased in the DM and DM + LDR groups,particularly in DM group.The blood glucose(BG)level in the DM + LDR groups was higher than that in the control,but decreased significantly as compared with that in the DM group(P < 0.01).As compared with those in the control,the apoptotic rate in DM + 50 mGy(P < 0.05)and the content of serum IL-2 in DM + 75 mGy group(P < 0.01)all increased significantly,while the content of IL-2 in supernatant of cultured splenocytes decreased significantly in the DM + LDR groups.Compared with those in the DM group,the apoptotic rate and the percentage of TCRαβ in splenocytes in the DM + LDR groups(P < 0.01-P < 0.001)and the content of IL-2 in serum in DM + 50 mGy group(P < 0.01)decreased significantly.Conclusions The multiple LDR could weaken the loss of BW and increase of BG caused by DM,decrease the splenocyte apoptosis induced by DM,and regulate the immune factors.

Objective To observe the effects of purified product trihydroxybenzoic acid dimmer in different doses from Trapa manshurica Fler on apoptosis and cell cycle progression of liver cancer SMMC-7721 cells in vitro and explore its possible mechanism of inhibiting tumor growth. Methods The changes of apoptosis and cell cycle progression were measured with flow cytometry. Results The apoptotic percentages of the cells treated with the purified products with doses of 3.125, 6.250, 12.500 and 25.000 mg?L~ -1 increased significantly as compared with that in the control (P

Objective To observe the effects of 3,4,5-trihydroxybenzoic acid dimmer (TAD) in different doses on apoptosis and cell cycle progression of liver cancer SMMC-7721 cells in vitro and explore its possible mechanism of inhibiting tumor growth.Methods The experiment was divided into 0,3.125,6.250,12.500 and 25.000 ?g TAD groups. Apoptosis was observed with JEM-1200EX transmission electron microscope (TEM).The changes of apoptosis and cell cycle progression were measured with flow cytometry.Results The typical features of apoptosis were found in tumor cells,the nuclei were broken to pieces,mitochondrion cristae were disrupted and vacuoles were showed in nucleus and cytoplasm in 25.000 ?g TAD group observed under TEM.Meantime,the apoptotic percentages of the cells treated with 3.125—25.000 ?g TAD were increased significantly as compared with control group (P

Objective:To study effects of large dose thymopeptides on T cell subpopulations of patients with malignant tumor under radiotherapy.Methods:Fifty one patients with malignant tumor under radiotherapy were divided into 2 groups with 100 mg and 200 mg thymopeptides respectively.The patients we re given thymopeptides,100 mg/d or 200 mg/d,iv, for 10 days.The positive percent ages of CD4,CD8,CD25 and CD56 in T cells of peripheral blood before and after thymopeptide treatment were determined by flow cytometry.Results:The positive percentages of CD4 and CD25 in T cells of peripheral bl ood after 100 mg/d thymopeptide treatment were significantly higher than those befor e thymopeptide treatment (P<0.05),while those of CD4，CD8，CD25 and CD56 in T cells of peripheral blood after 200 mg/d thymopeptide treatment all increased significantly (P<0.05 or P<0.01). Conclusion:These results suggest that large dose of thymopeptides can increase i mmune function of patients with malignant tumor under radiotherapy,and the curat ive effect of 200 mg/d thymopeptides is better.