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Objective:To develop a novel, flexible, dual-arm, master-slave digestive endoscopic minimally invasive surgical robot system named dual-arm robotic endoscopic assistant for minimally invasive surgery (DREAMS) and to evaluate its feasibility for endoscopic submucosal dissection (ESD) by using ex vivo porcine stomachs.Methods:A novel endoscopic robot (DREAMS) system was developed which was composed of a flexible two-channel endoscope, two flexible robotic manipulators, a master controller, a robotic arm, and a control system. A total of 10 artificial round-like lesions with diameters ranging from 15 to 25 mm were created (5 in gastric antrum and 5 in gastric body) by using fresh peeled stomach of healthy pigs as the model. Submucosal dissection was performed with the assistance of the DREAMS system by two operators. The main outcome was submucosal dissection speed, and the secondary outcomes included muscular injury rate, perforation rate, and grasping efficiency of the robot.Results:All 10 lesions were successfully dissected en bloc by using the DREAMS system. The diameter of the artificial lesions was 22.34±2.39 mm, dissection time was 15.00±8.90 min, submucosal dissection speed was 141.79±79.12 mm 2/min, and the number of tractions required by each ESD was 4.2 times. Muscular injury occurred in 4/10 cases of ESD. No perforation occurred. Conclusion:The initial animal experiment shows the DREAMS system is safe and effective.
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Objective@#To verify the safety and efficacy of IONTRIS particle therapy system (IONTRIS) in clinical implementation.@*Methods@#Between 6.2014 and 8.2014, a total of 35 patients were enrolled into this trial: 31 males and 4 females with a median age of 69 yrs (range 39-80). Ten patients had locally recurrent head and neck tumors after surgery, 4 cases with thoracic malignancies, 1 case with hepatocellular carcinoma, 1 case with retroperitoneal sarcoma, and 19 cases with non-metastatic prostate carcinomas. Phantom dose verification was mandatory for each field before the start of radiation.@*Results@#Twenty-two patients received carbon ion and 13 had proton irradiation. With a median follow-up time of 1 year, all patients were alive. Among the 16 patients with head and neck, thoracic, and abdominal/pelvic tumors, 2, 1, 12, and 1 cases developed complete response, partial response, stable disease, or disease progression, respectively. Progression-free survival rate was 93.8% (15/16). Among the 19 patients with prostate cancer, biological-recurrence free survival was 100%. Particle therapy was well tolerated in all 35 patients. Twenty-five patients (71.4%) experienced 33 grade 1 acute adverse effects, which subsided at 1 year follow-up. Six (17.1%) patients developed grade 1 late adverse effects. No significant change in ECOG or body weight was observed.@*Conclusions@#IONTRIS is safe and effective for clinical use. However, long term follow-up is needed to observe the late toxicity and long term result.
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Objective Multiple software applications and systems and complex hardware are utilized in the process of radiotherapy. In this paper,Xenapp-based visualized system was adopted to integrate each system during the radiotherapy procedures. Methods Windows2008r2 operating system,Citrix Xenapp 6. 5 sp1 enterprise edition,sqlserverr2008 express database were utilized. The Xenapp server was installed and the commonly used software applications were installed and published on this server. CitrixReceiver was installed on the computers in the local network in Department of Radiotherapy. A web browser was utilized to log in the Xenapp server to access all the applications published on the server. Results The application of Citrix Xenapp-based virtualized system significantly reduced the cost of computer hardware by more than 50％,decreased the maintenance cost of technical personnel. Besides,it made the process of Department of Radiation Oncology seamless and improved the efficiency of the staff in the Department of Radiation Oncology. Conclusions The Xenapp-based virtualized system can save cost and improve efficiency in the process of radiotherapy,which is worthy of widespread application in clinical practice.
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Objective To evaluate the effect of isoflurane on the expression of phosphorylated glycogen synthase kinase-3 beta (p-GSK-3β) and β-catenin in neural stem cells (NSCs) in the hippocampus of developing rats.Methods Twenty-four 7-day-old Sprague-Dawley rats,weighing 15-20 g,were divided into 2 groups (n =12 each) using a random number table:control group (group C) and 2％ isoflurane group (group Ⅰ).Group C inhaled 30％ oxygen for 4 h.Group Ⅰ inhaled 2％ isoflurane in 30％ oxygen for 4 h.Six rats were randomly selected from each group,and 5-bromodeoxyuridine (BrdU) 200 mg/kg was intraperitoneally injected immediately before anesthesia to assess the proliferation of NSCs in the hippocampal dentate gyrus.The rats were sacrificed at 6 h after the end of anesthesia,and hippocampi were isolated for determination of the number of BrdU positive cells in the dentate gyrus (by immunohistochemistry) and expression of p-GSK-3β and β-catenin in hippocampal tissues (by Western blot analysis).Results Compared with group C,the number of BrdU positive cells was significantly decreased,and the expression of p-GSK-3β and β-catenin was down-regulated in group Ⅰ (P＜0.05).Conclusion Isoflurane can inhibit the proliferation of NSCs in the hippocampal dentate gyrus of developing rats,and the mechanism may be related to down-regulation of the expression of p-GSK-3β and β-catenin.
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Objective The positron generated at the dose deposition site by using high-energy carbon ions to hit the material annihilate with the negative electron in the material to release the gamma photon.The positron-emitting isotope (PEI) distributions in the target volume are activated significantly by carbon ions.Therefore, the mean values of positron emission tomography (PET) activity could be related to the delivered doses to the clinical target volume from carbon ion.This specialty can be used for the image registration fusion of the carbon ion treatment planning computed tomography (CT) and treatment verification PET-CT.After radiation in the almost same decay period, the relationship between the different target volume and the PET-CT SUV of different every single fraction dose can be found, then the range of SUV for the radiation target could be decided.So this PET-CT standardized uptake value (SUV) range can also provide a reference for the correlation and consistency in planning target dose verification and evaluation for the clinical trial.Methods The head phantom was used as a simulation of the real human body, the 1 cc, 4 cc, and 10 cc cube volume target contouring were done in the TPS, the 90 degree fixed carbon ion beams were delivered in different single fraction effective dose of 2.5 GyE, 5 GyE, and 8 GyE.After the beam delivery, later the PET-CT scanning was performed and parameters of scanning followed the trial regulation.The MIM Maestro software was used for the image processing and fusion to determine the maximum, minimum, average, and total values of SUV in the virtual clinical target volumes for the different single fraction dose.Results The results showed that for the same target volume, the SUV range of target had an approximate linear correlation with effective dose of target (P=0.000).The same effective dose for the different target volumes got the same SUV range (P>0.05).Conclusions For the carbon ion treatment plan, the SUV range from image registration and fusion of planning CT and PET-CT after treatment can be used to make an evaluation for accuracy of the dose distribution.And this method also could be used in the hyper-fraction treatment plan.In the SUV range research of different decay periods, the similar method can be performed for the exploration.
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Objective To evaluate the effect of isoflurane anesthesia on Wnt3a expression in the hippocampus of developing rats.Methods Twenty-four 7-day-old male Sprague-Dawley rats,weighing 125-155 g,were randomly divided into 3 groups (n=8 each) using a random number table:control group (group C),4 h inhalation of 2％ isoflurane group (group I4),and 6 h inhalation of 2％ isoflurane group (group I6).The rats were sacrificed at 6 h after the end of treatment in each group,and the hippocampi were removed for determination of Wnt3a mRNA expression (by real-time reverse transcriptase polymerase chain reaction) and Wnt3a expression (by Western blot).Results Compared with group C,the expression of Wnt3a and Wnt3a mRNA in hippocampi was significantly up-regulated in I4 and I6 groups (P＜0.05).Compared with group I4,the expression of Wnt3a in hippocampi was significantly up-regulated (P＜0.05),and no significant change was found in the expression of Wnt3a mRNA in hippocampi in group I6 (P＞0.05).Conclusion The mechanism of isoflurane-induced neurotoxicity is probably related to upregulation of Wnt3a expression in the hippocampal tissues of developing rats.
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The computer access, such as special mouse keyboard, software of the voice input and the magnified or reading screen, etc., can facilitate the people with disabilities to use the computer more efficiently. The computer access adaption should be evaluated to meet the users' needs, their function and the circumstances in which they live. The products should be easily designed, remade, and used for the cus-tomers and the prices should be available. For China, it is important to form professional teams, establish the good service process, achieve more supports, especially financial support, to research and develop more varieties of products.
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Background and purpose: Currently, intraoperative radiation therapy (IORT) has become the adjuvant therapy of cancer. The study was to establish the daily quality assurance (QA) program and analyze dosimetric characteristics’ long-term stability for mobile IORT accelerator. Methods:The QA program of this study included two parts:safety and functionality and energy and output. The two years’ QA datasets were acquired and analyzed to investigate the stability of energy and output. Results:All safety and functionality tests passed on a daily basis. The energy index was (0.666±0.015)mm, (0.839±0.009)mm, (0.781±0.010)mm, (0.724±0.009)mm and the output dose error was (0.511 ± 0.671)%, (0.278 ± 0.516)%, (0.368 ± 0.532)%, (0.382 ± 0.912)%for all energy, respectively. There was no signiifcant time trend in the dosimetric characteristics. Conclusion:The daily QA program is suitable for mobile IORT accelerator. The long-term stability is acceptable for IORT in clinical use.
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Objective To investigate the HLA antibody incidence and type renal recipients with different age, and to study the echaracteristics in different age patients, for clinical reference to forecast renal rejection in different age patients. Methods With serum dated from January 2006 to June 2008, patients were classified into three groups: young group, with age below 35 years; middle age group, with age from 36 to 50 years; and old group, with age above 50 years. Penel reactive antibody (PRA) were detected using ELISA. Results Pretransplant HLA antibody incidences in the young, middle age, old group were 18.18%, 23.00% and 6.19%, respectively. In young group, HLA antibody incidences were 5.59% and 8.51% in male and female respectively. In middle age group, they were 21.30% and 25.38% in male and female respectively. In old group, they were 11.36% and 25.00% respectively. HLA Ⅰ and HLA Ⅰ + Ⅱ antibodies were mainly found in all the three groups in pretansplant. Conclusion HLA Ⅰ and HLA Ⅰ + Ⅱ antibodies were mainly found in pretransplant. Antibody incidence was higher in patients who had more than once renal transplant than that in transfusion and pregnancy female. Antibody incidence is higher in female than that in male.
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Objective To analyze the sensitized factors in urinemia patients who waiting for renal transplantation.Methods 2429 patients with urinemia from April 2002 to December 2008 were subjected to the detection of panel reactive antibody, and classified into 5 groups according to their clinical data:(A) no history disease group (n = 1097) who never experienced transfusion, pregnancy and transplantation; (B) Transfusion group (n = 361) who received transfusion more than 200 ml; (C) Pregnancy group (n = 481) who experienced pregnancy; (D) Transfusion+ pregnancy group (n= 294) who experienced both pregnancy and transfusion; (E) Re-transplantation group (n = 196) who experienced failed transplantation before, and waited for the second renal transplantation.Results All the males in group A were negative for PRA, and females were weakly positive for HLA Ⅱ antibody.The incidence of PRA production in group B was 15.24 % (55/361).Thirty-nine patients were positive for PRA in group C with the incidence being 8.11 % (39/481).The PRA positive rate in groups D and E was 30.61 % (90/294) and 70.92 % (139/196) respectively.PRA intensity was more than 60 % in 72 patients in group E.Conclusion Transfusion and pregnancy caused lower incidence of PRA positive rate.The incidence was much higher in transfusion + pregnancy patients than that in patients with transfusion or pregnancy alone.Graft caused the higher incidence of PRA than by transfusion and pregnancy.