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【Objective】 To investigate the correlation between early immune reconstitution and clinical outcomes in patients with acute lymphoblastic leukemia (ALL) underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT). 【Methods】 The basic information and treatment data of 99 patients with ALL undering allo-HSCT from December 2018 to February 2022 were collected. The proportions of CD3+ T, CD3+CD4+ T, CD3+CD8+ T and CD3-CD16+CD56+ NK cells were detected before and 30, 60 and 90 days after transplantation using flow cytometry. The correlation between early cellular immune reconstitution and neutrophil engraftment, platelet engraftment, infection, and acute and chronic graft-versus-host disease (GVHD) was analyzed. 【Results】 Among 99 ALL patients, the median time of neutrophil engraftment was day +11 (range, 8-28), and the median time of platelet engraftment was day +14 (range, 10-120). The cumulative incidence of blood stream infection (BSI) was 11.10% and the cumulative incidence of CMV within 100 days of transplantation was 40.40%. The cumulative incidence of EBV within 100 days was 7.10%. The cumulative incidence of acute graft-versus-host disease (aGVHD) was 22.30%. The cumulative incidence of chronic graft-versus-host disease (cGVHD) within 1 year of transplantation was 16.20%. 1 -year cumulative relapse rate was 13.84%. The 1 -year cumulative disease-free survival (DFS) for all patients was 80.60% and the 1-year overall survival (OS) was 90.30%. The CD4+/CD8+ ratio was positively associated with the development of aGVHD at 30 days post-transplant (OR 1.21, 95CI 1.01-1.45, P<0.05). The proportion of CD16+ CD56+ NK cell were higher in the group without BSI than that in the BSI group before and 30 days after transplantation (P < 0.05). The proportion of CD4+ T-cell were lower in the CMV infection group than that in the group without CMV infection at 60 and 90 days post-transplant(P<0.05). The higher level of CD4+ T-cells at 60 days post-transplant was a protective factor for CMV infection within 100 days (HR 0.91, 95CI 0.84-0.99, P<0.05). 【Conclusion】 Early immune reconstitution after allo-HSCT in patients with ALL is associated with aGVHD, CMV and BSI.
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Objective:To investigate the changes, distribution and influencing factors of ocular dominance after small incision lenticule extraction (SMILE).Methods:A retrospective observational case series study was conducted.One hundred and twelve patients (224 eyes) with an average age of 25.1±5.4 years who underwent SMILE surgery at Tianjin Eye Hospital from November 2017 to February 2018 were enrolled.There were 42 male and 70 female patients.The dominant eye was determined using the hole-in-the-card test before and after the surgery.Subjective and objective refraction and uncorrected visual acuity examination were performed before operation, and 1 day, 1 week, 1 month and 3 months after operation.The subjects were divided into switch group and non-switch group based on whether the dominant eye changed after surgery.Binary logistic regression was used to analyze the main influencing factors of dominant eye switches.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Tianjin Eye Hospital (No.201905). Written informed consent was obtained from each patient before any medical examination.Results:There were 18 patients (16.1%) in the switch group including 7 males (38.9%) and 11 females (61.1%), and 94 patients (83.9%) in the non-switch group including 35 males (37.2%) and 59 females (62.8%). No statistically significant difference was found in sex between the two groups ( χ2=0.02, P=0.89). At 1 month and 3 months after the surgery, there was a statistically significant difference in the cylindrical power between the dominant and non-dominant eye ( t=2.31, 1.95; both at P<0.05). Binary logistic regression equation showed that spherical equivalent[odds ratio ( OR)=0.47, 95%confidence interval ( CI): 0.35-0.66]and refractive error difference ( OR=3.04, 95% CI: 2.12-4.36) were significantly related to the eye dominance switches. Conclusions:There were 16.1% of patients having eye dominance switches after SMILE.The dominant eye transfomation is associated with higher spherical equivalent and anisometropia difference before surgery.
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Immune checkpoint inhibitors(ICIs)treatment significantly prolonged the survival period of patients with lung cancer, liver cancer, and malignant melanoma and other solid malignant tumors and improved the quality of life.But at the same time a variety of immune-related adverse reactions(irAEs)appeared.The incidence of immune-mediated liver injury(IMH)caused by ICIs is increasing but the severity is different.To diagnose IMH earlier and perform individualized diagnosis and treatment, it is necessary to have a reasonable application of drug treatment.
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Objective:To investigate the correlation between serum cystatin C (Cys C) and left ventricular geometry in patients with obstructive sleep apnea syndrome (OSAS) complicated with prehypertension(PH).Methods:A total of 408 patients with PH and OSAS diagnosed by polysonogram monitoring in the sleep monitoring room of Respiratory Department, the First Hospital of Shanxi Medical University from July 2018 to June 2021 were collected. Serum Cys C concentration and echocardiography were performed in all patients. According to the classification of left ventricular geometry, all patients were divided into four groups: normal configuration (NG) group( n=297), concentric remodeling (CR) group( n=49), eccentric hypertrophy (EH) group( n=33), and concentric hypertrophy (CH) group( n=29). General clinical data, sleep parameters, blood biochemical parameters, Cys C concentration and echocardiographic parameters were compared among the four groups, and the correlation between serum Cys C and left ventricular geometry was analyzed. Results:①The serum Cys C concentration increased successively from NG group, CR group, EH group to CH group, and the increase in CH group was the most obvious ( P<0.05). In addition, there were statistically significant differences in body mass index (BMI), waist circumference, systolic blood pressure (SBP), diastolic blood pressure (DBP), severity of OSAS, the percentage of the time that the blood oxygen saturation was less than 90% of the total sleep time (T90), lowest oxygen saturation (Lowest-SaO 2), mean oxygen saturation (Mean-SaO 2), left ventricular end diastolic diameter (LVEDD), inter-ventricular septal diameter (IVST), left ventricular posterior wall thickness diameter (LVPWT), left ventricular mass index (LVMI), relative wall thickness (RWT), left ventricular ejection fraction (LVEF) and E/A among all groups (all P<0.05). ②Multivariate Logistic regression analysis showed that Cys C was independently correlated with CR (β=0.721, OR=2.057, P=0.047), EH(β=0.961, OR=2.614, P=0.017) and CH (β=1.180, OR=3.254, P=0.010). Conclusions:There is a correlation between serum Cys C and left ventricular geometry in OSAS patients with PH, suggesting that serum Cys C might be involved in the change of left ventricular geometry.
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Objective:To investigate the influence of angle Kappa on total high-order aberration (HOA) before and after small incision lenticule extraction (SMILE).Methods:An observational case series study was conducted.Right eyes of 98 patients with myopia and myopic astigmatism who underwent SMILE surgery at Tianjin Eye Hospital from April 2015 to May 2016 were selected.Uncorrected visual acuity (UCVA), spherical diopter and cylindrical diopter under cycloplegic condition were examined before the surgery and at l and 3 months postoperatively.The chord distance of angle Kappa was measured by Pentacam topography.Wavefront aberrations were measured by WaveScan aberrometer.Pre- and postoperative UCVA, refractive status and each HOA were analyzed.The relationship between angle Kappa and each HOA was analyzed by Pearson correlation.This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of Tianjin Eye Hospital (No.TJYYLL-2017-17). Written informed consent was obtained from each subject.Results:The preoperative, postoperative 1-month and postoperative 3-month UCVA (LogMAR) were 0.06±0.23, -0.03±0.07 and -0.05±0.07, respectively, showing a statistically significant difference ( F=779.330, P<0.001). There were statistically significant differences in spherical diopter, cylinder diopter and spherical equivalent (SE) between before and after operation ( F=1 107.811, 127.786, 1 191.266; all at P<0.001), and the postoperative spherical diopter, cylinder diopter and SE were significantly lower than those before surgery (all at P<0.001). At 6-mm pupil diameter, significant differences were found between postoperative total HOA, spherical aberration, coma, the third-order aberration (S3), fourth-order aberration (S4), fifth-order aberration (S5) and sixth-order aberration (S6) and the preoperative values ( F=75.915, 78.231, 66.186, 64.521, 97.161, 36.623, 28.852; all at P<0.001). The postoperative 1- and 3-month total HOA, spherical aberration, coma, S3, S4, S5 and S6 were significantly increased in comparison with those before surgery (all at P<0.05). There was a positive correlation between angle Kappa and total HOA, coma and S3 at 1 and 3 months after surgery (total HOA: r=0.357, 0.363; both at P<0.001.coma: r=0.310, 0.341; both at P<0.01.S3∶ r=0.343, 0.371; both at P<0.01). Significant differences were found in preoperative, postoperative 1-month and 3-month total HOA, coma and S3 between groups with different angle Kappa ( Fgroup=3.363, 4.277, 4.029; all at P<0.05). The postoperative total HOA, coma and S3 of the larger angle Kappa group were greater than those of the smaller angle Kappa group, with statistically significant differences between them (all at P<0.05). Conclusions:A larger angle Kappa may induce HOAs in SMILE surgery.
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Objective:To investigate and compare the changes of modulation transfer function (MTF) after small-incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis(FS-LASIK).Methods:A cohort study was conducted.One hundred and two myopic patients (102 eyes) who underwent SMILE and FS-LASIK in Tianjin Eye Hospital from December 2015 to June 2016 were enrolled and divided into SMILE group with 53 eyes and FS-LASIK group with 49 eyes according to different surgical methods.The ocular aberrations and corneal morphology of all patients were measured by the Hartman-Shack wave-front analyzer and Pentacam topography before surgery and 1, 3 and 6 months postoperatively.MTF of optic system was calculated and analyzed.The changes of MTF values were compared between the two groups at different time points under different spatial frequencies, after removal of low-order aberrations at postoperative 6 months, and after removal of vertical coma aberration, horizontal coma aberration and spherical aberration in the SMILE group at postoperative 6 months.The study protocol complied with the Declaration of Helsinki and was approved by an Ethics Committee of Tianjin Eye Hospital (No.TJYYLL-2014-17). Written informed consent was obtained from each patient before surgery.Results:Compared with the preoperative MTF, there were significant increases in postoperative 1-, 3- and 6-month MTF at all spatial frequencies in the SMILE group and FS-LASIK group (all at P<0.05). MTF values at all spatial frequencies in the SMILE group were significantly higher than those in the FS-LASIK group at 1, 3, and 6 months after surgery (all at P<0.05), except at 55 c/d and 60 c/d at 6 months postoperatively.The postoperative 6-month MTF values at all spatial frequencies without low-order aberration were higher in the SMILE group than those in the FS-LASIK group, showing significant differences between the two groups (all at P<0.05). In the SMILE group, the postoperative 6-month MTF values at 1 c/d spatial frequency without the horizontal coma aberration and spherical aberration were significantly higher than the preoperative MTF values (both at P<0.01); the postoperative 6-month MTF values at 1 c/d and 3 c/d spatial frequency without vertical coma aberration were significantly higher than the preoperative MTF values (both at P<0.05), and there were no statistically significant differences between the postoperative 6-month MTF values at the other spatial frequencies with and without single high-order aberrations (all at P>0.05). Conclusions:Optic quality has been obviously improved after SMILE and FS-LASIK, and the SMILE is superior to FS-LASIK in the MTF value.
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Objective:To investigate the changes of refraction power and higher-order aberrations under mesopic and photopic vision conditions.Methods:A cross-sectional study was performed.Seventy-one eyes of 71 patients with myopia or myopic astigmatism were enrolled in Tianjin Eye Hospital from February 6 to 28 in 2017.Spherical diopter, cylindrical diopter and higher-order aberrations were examined with NIDEK OPD Scan-Ⅲ.The pupil size, refractive power, total higher-order aberrations and Zernike aberration coefficients were compared between mesopic and photopic conditions.The study protocol was approved by an Ethics Committee of Tianjin Eye Hospital.Written informed consent was obtained from each subject prior to any medical examination.Results:The mean pupil diameter of the photopic conditions was significantly smaller than that of mesopic condition ( t=-66.730, P<0.001). The mean spherical equivalent (SE) were (-6.85±2.75)D and (-6.50±2.38)D under mesopic and photopic conditions, and mean cylindrical diopter were (-1.27±0.91)D and (-0.84±0.76)D, respectively, with statistically significant differences between the two conditions (both at P<0.001). There was no significant difference in spherical diopter between photopic and mesopic conditions ( P=0.212). The root mean square (RMS) values of total higher order aberration, total trefoil, total coma and total spherical aberration under mesopic condition were significantly higher than those under photopic condition (all at P<0.001), and the RMS values of Zernike aberration coefficients were significantly increased in mesopic condition compared with the photopic condition (all at P<0.001). Conclusions:Both refractive power and higher-order aberrations in photopic condition are higher than those in mesopic condition.
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Objective:To study the pupillary centroid shift of myopia and characteristics of pupil diameter change from scotopic to photopic condition.Methods:A case series study was carried out, 140 eyes of 70 myopia patients from September to November 2016 in Tianjin Eye Hospital were enrolled.The pupillary centroid shift and pupil diameter parameters were measured by visual quality analyzer from scotopic (0.017 lx) to photopic (10.400 lx) condition.This study followed the Declaration of Helsinki.Results:Under the scotopic and photopic conditions, the pupil diameter was positively correlated between the bilateral eyes (scotopic: rs=0.85, P<0.001; photopic: r=0.85, P<0.001), and the pupil diameter variation from scotopic to photopic condition was positively correlated between the bilateral eyes ( r=0.75, P<0.001). The pupil diameter in scotopic and photopic conditions, and the change of pupil diameter in the right eyes were significantly higher than those in the left eyes (all at P<0.05). The pupillary centroid shift was within 0.2 mm in the left eyes of 94.2% (66/70) subjects and in the right eyes of 97.1%(68/70) subjects.The pupillary centroid shift of all subjects was within 0.3 mm.From scotopic to photopic condition, the pupil centroid was mainly shift to the nasal superior direction.There was no significant correlation between pupil diameter and age or gender.There was no significant correlation between pupillary centroid shift and age, diopter or pupil diameter. Conclusions:The binocular pupillary centroid shift are symmetrical from scotopic to photopic condition in myopic eyes, and the pupil centroid mainly shift to nasal superior direction.
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Objective@#To investigate the effect of simple artifacts on the calculation of radiation dose in actual clinical operations by the aid of artificially caused CT artifacts.@*Methods@#The phantom was scanned using CT before and after replacing the titanium alloy component. Then, the CT values were measured at different distances before and after replacement. After correcting the CT value of the titanium alloy region to the CT value of the water phantom, the doses to the phantom were calculated by using Varian′s AAA algorithm, AXB algorithm and Pinnacle system′s CCC algorithm. The absolute dose values at different distances were furtherly analyzed.@*Results@#Varian system was consistent with Pinnacle system in evaluating the CT values. When the CT value deviated by less than 30 HU for a uniform phantom, the dose deviations of the three different algorithms were within 6.0 %-12.0 % at a distance of 0.5 cm from the body surface, and less than 1.0% at a distance of more than 1.5 cm from the body surface. When the CT value deviated by 15 HU for the lung phantom, both Varian′s AAA algorithm and Varian′s AXB algorithm showed about 1.0% dose deviation. However, the CCC algorithm of the Pinnacle system had a significant difference (5.0%) in dose values under the same conditions.@*Conclusions@#CT artifacts have noticeable effects on the calculation of radiation dose and change tissue dose distribution which may result in insufficient or excessive exposure doses.
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OBJECTIVE@#To investigate the distribution of Chinese medicine (CM) syndrome in patients with acute myocardial infarction (AMI) on admission and its impact on prognosis.@*METHODS@#A total of 525 AMI patients were prospectively recruited and classifified into 4 groups based on their clinical characteristics: excess-heat, excess-cold, deficiency-heat and deficiency-cold syndromes. Major adverse cardiovascular events (MACEs) were followed up.@*RESULTS@#The excess syndrome was more common than deficiency syndrome (72.95% vs. 27.05%; P<0.05). Totally 495 (94.29%) of 525 AMI patients were followed up (median 277 days). There were 59 (11.92%) MACEs. After adjusted with confounding factors in Cox regression models, the hazard ratio (95% confifidence interval) of excess-heat, excess-cold, defificiency-heat and defificiency-cold syndrome groups were 1, 1.25 (0.63, 2.49; P<0.05), 2.37 (1.14, 4.94; P<0.05), 3.76 (1.71, 8.28; P<0.05), respectively.@*CONCLUSIONS@#Excess syndrome was more common in AMI patients and had better prognosis, while defificiency-cold syndrome had the poorest prognosis. CM syndrome was of value in predicting long-term outcomes in AMI patients.
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Objective To evaluate the influences of various field-defining method of Varian accelerator on radiation dosimetry parameters, and provide theoretical basis for the beam modeling of the treatment planning system ( TPS ) . Methods The percentage depth dose ( PDD ) , the off-axis ratio ( OAR ) and the total scattering factors ( Scp ) of radiation fields were measured in three different conditions, including collimators (JAW), multileaf collimator(MLC) and JAW +MLC. The measured data was analyzed and compared with each other. Results The PDD of central axis was marginally influenced by three field-defining method. In both directions, the MLC-defined field sizes were larger by a maximum of 2. 9 mm ( left-right) or 1. 7 mm ( gun-target) than the JAW-defined ones. In the left-right direction, the width of field penumbra shaped by MLC was larger than the field of the same size as defined by JAW. The result of gun-target direction was to the contrary. In both directions, the field penumbra and size displayed no significant differences as defined by JAW+MLC or JAW. Conclusions The field size, penumbra width, and the total scattering factors were influenced by field-defining method, which indicates that special attention should be paid to the dosimetric parameters of MLC during TPS beam modeling for IMRT planning.
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Objective To evaluate the influences of various field-defining method of Varian accelerator on radiation dosimetry parameters, and provide theoretical basis for the beam modeling of the treatment planning system ( TPS ) . Methods The percentage depth dose ( PDD ) , the off-axis ratio ( OAR ) and the total scattering factors ( Scp ) of radiation fields were measured in three different conditions, including collimators (JAW), multileaf collimator(MLC) and JAW +MLC. The measured data was analyzed and compared with each other. Results The PDD of central axis was marginally influenced by three field-defining method. In both directions, the MLC-defined field sizes were larger by a maximum of 2. 9 mm ( left-right) or 1. 7 mm ( gun-target) than the JAW-defined ones. In the left-right direction, the width of field penumbra shaped by MLC was larger than the field of the same size as defined by JAW. The result of gun-target direction was to the contrary. In both directions, the field penumbra and size displayed no significant differences as defined by JAW+MLC or JAW. Conclusions The field size, penumbra width, and the total scattering factors were influenced by field-defining method, which indicates that special attention should be paid to the dosimetric parameters of MLC during TPS beam modeling for IMRT planning.
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Objective To explore the clinical significance of combination detection of serum squamous cell carcinoma antigen (SCC-Ag) and carcino-embryonic antigen (CEA) for the diagnosis,effect evaluation,monitoring and prognosis in cervical carcinoma.Methods Four hundred and twenty-four cases of cervical carcinoma patients diagnosed by pathology and 400 binign gynaecology patients were selected to detect levels of SCC-Ag and CEA by ELISA.Besides,the pelvic color ultrasound results of cervical carcinoma patients were collected and analyzed.Results The positive rates of serum SCC-Ag,CEA and combined detection of cervical carcinoma patients were 55.9 ％(237/424),26.4 ％(112/424),61.8 ％(262/424),which were higher than those of binign gynaecology patients [12.0 ％(48/400),12.5 ％(50/400),14.5 ％(58/400)],and the differences were statistical significance (all P＜ 0.05).The sensitivity of combined detection of SCC-Ag and CEA for diagnosing cervical carcinoma (61.8 ％) was better than that of detection of alone SCC-Ag or CEA (55.9 ％,26.4 ％),and the difference was statistical significance (P ＜ 0.05).The differences of pretreatment serum SCC-Ag and CEA levels in the cervical carcinoma patients who were dependent on clinical stage,pathological type,depth of invasion,lymph node metastasis were statistically significant (all P ＜ 0.05).The combined detection of SCC-Ag and CEA in patients with stage Ⅰ and Ⅱ had higher positive rates [45.5 ％ (71/156),73.2 ％(139/190)] than those of the ultrasound examination [33.3 ％(52/156),51.1％(97/150)] (P＜ 0.05).After surgery or concurrent chemoradiotherapy or surgery combined radiation and chemotherapy,SCCAg levels of patients in post-treatment (median 0.34,0.51,0.33 ng/ml) were much lower than those of pretreatment (median 0.48,3.44,1.29 ng/ml),and CEA levels of post-treatment (median 0.75,0.81,0.71 ng/ml)were also lower than those of pre-treatment (median 1.22,1.53,1.50 ng/ml) (P ＜ 0.05).After treatment,cervical cancer patients with the raised or not decreased to the normal range levels of SCC-Ag and CEA had recurrences or metastasis rates of 33.3 ％(6/18),56.5 ％(13/23) and 46.1％(35/76).Survival rate of the patients with positive SCC-Ag was significantly lower than that of patients with negative (P ＜ 0.05),while the survival rate of patients with positive or negative CEA had no difference (P ＞ 0.05).Conclusions Combined detection of SCC-Ag and CEA can be used as an important indicator to estimate clinical stage,pathological type,depth of invasion,lymph node metastasis,curative effect and prognosis of cervical carcinoma.Combined detection of SCC-Ag and CEA had higher positive rates than pelvic color ultrasound examination for cervical carcinoma patients in stage Ⅰ and Ⅱ.
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Objective To investigate the application of a self-made positioning device in CT-MRI image fusion in patients with laryngeal tumor,as well as the precision of image fusion and the changes in target volume delineation after fusion.Methods A total of 10 patients with laryngeal cancer were enrolled,and a self-made positioning device was used to collect CT and MRI images in a fixed position.These images were fused by mutual information combined with manual fusion.The precision of image fusion was assessed by the positional deviation of internal and external markers and degree of gross tumor volume (GTV) overlap (PCT-MRI) between CT and MRI images.GTV was contoured based on CT images (VCr),MRI images (VMRI),and fused images (VCT+MRI).The overlapped volume of VCT and VMRI(VCT-MRI) Was calculated,and the target volume was analyzed and compared.Results The positional deviations of three external markers in the three directions were 0.996±0.222 mm,1.146±0.291 mm,and 1.368±0.298 mm (P=0.000),respectively,while those of the internal markers were 0.476±0.151 mm,0.561±0.083 mm,and 0.724± 0.125 mm (P=0.000),respectively.VCT,VMRI,VCT+MRI,and VCT-MRI were 26.355±7.876 cm3,33.556± 7.407 cm3,40.036±7.627 cm3,19.875±8.588 cm3(P=0.000),respectively.PCT-MRI was 73.7％±9.8％.Conclusions The self-made positioning device can improve the consistency of position during the collection of CT and MRI images,and fused CT-MRI images can provide more information and improve the precision of target volume delineation.
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Objective To study the clinical application of Compass (R) system,a novel 3D quality assurance system for the verification of esophageal carcinoma intensity-modulated radiotherapy (IMRT) plan.Methods 12 esophageal carcinoma IMRT plans were optimized with Eclipse 8.6 treatment planning system (TPS),and then Compass (R) reconstructed 3D dose distributions with the patient anatomy.Comparison was performed among the reconstructed and calculated with TPS,Dose-volume parameters (γ pass rate、average dose deviation) to the planning target volume (PTV) and critical structures were quantitative valuated.Furthermore two-dimensional dose verification were performed use MatriXX,γ pass rate were evaluated with 3％/3 mm criteria.Results The γ pass rate of actual gantry angle was found generally declined seemingly compared with 0 degree gantry angle in two dimensional verification,difference was statistically significant (P =0.018-0.001).In 3D dose verification,the γvolume of PTV were exceed 93％,the deviation of D95,D50,D2 were less than 3％;The γvolume of lungs and heart were exceed 95％,the average dose deviation were less than 3％;The γ pass rate of spinal cord and trachea were exceed 98％.The independent check verified more conformed with the TPS calculated.Dose deviations appeared in the radiation field edge area.Conclusions 3D dose verification can provide more information to comprehensively evaluate the plan which is benefit for evaluating the clinical value of verification.
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Objective To test the accuracy of a three-dimensional dose verification system CompassR,which reconstructing dose distribution based on measurements and independent dose calculation,and to evaluate the feasibility of its application in clinical intensity-modulated radiotherapy (IMRT) quality assure.Methods A set of square-wave chart patterns of 2 cm,1 cm and 0.5 cm gaps was designed and 11 completed IMRT lung plans were selected for the test.EDR2 film and the ionization chamber were used for test and verifying of plane dose distribution and some special points dose of CompassR.The IMRT phantom plans were verified by CompassR with three-dimension based on anatomical information.Parameters including the volume γ pass rate and the average dose deviation were tested using dose volume histograms.Results In square-wave chart patterns test,the dose distribution reconstructed and calculated by CompassR coincided with the measurement using film.The γ pass rates (3％/3 mm,2％/2 mm) exceeded 90％.When the width of field is 0.5 cm,the γ pass rate was a little lower on account of the penumbra zone.Compared to the dose distribution profile which was measured by film,the maximum deviations of the dose distribution profile which was reconstructed and calculated by CompassR were 3.21％ and 2.70％.The absolute dose deviation of specific point in the IMRT plans was less than 3％,the maximum deviation occurred in the lung.Compared to film,the averageγpass rates on the isocenter plain in IMRT plan were (94.65 + 1.93)％ (3％/3 mm) which was reconstructed by CompassR.In three-dimensional dose verification,the volume γ pass rates of targets and risk organs were not less than 90％,and the deviation of average dose was less than 1％.Conclusions Accuracy of the tested system satisfies the demand of IMRT dose verification.CompassR could provide information of volumetric dosimetry and anatomical location of dose error,which is benefit for evaluating the clinical value of verification result.
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Objective: To explore the expression and gene amplification status of human epidermal growth factor receptor-2 (HER2) in the different stages of invasive urothelial bladder carcinoma. Methods:Tumor tissues from 49 patients with different stages of invasive urothelial bladder carcinoma were tested by immunohistochemical staining for HER2 and HER2 gene fluorescence in situ hybridization. Results:The number of male patients was higher than that of females. The positive rate of HER2 protein expression was higher in the patients with the higher stage of invasive urothelial bladder carcinoma. However, no gene amplification was observed in all patients. Twelve patients had ployploid chromosome 17. More ployploids were observed in the patients with the higher stage of inva-sive urothelial bladder carcinoma. Conclusion:The increase in the protein expression of HER2 in the invasive urothelial bladder carci-noma patients was not caused by gene amplification. Other transcriptional and post-transcriptional mechanisms were probably involved in the regulation of the HER2 protein.
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<p><b>OBJECTIVE</b>To establish the normal ranges for plasma N-terminal-pro-B-type natriuretic peptide (NT-proBNP) of middle-aged and elderly ( ≥ 40 years) healthy subjects in China.</p><p><b>METHODS</b>A total of 5133 subjects (2170 men and 2963 women) from the cohort of Shanghai Heart Health Study (SHHS) were included in this study. Plasma NT-proBNP was measured by electrochemiluminescence immunoassay. The reference values (2.5th- 97.5th quartiles) were determined using both empiric and quantile regression methods.</p><p><b>RESULTS</b>Plasma NT-proBNP values were higher in women than in men at all respective age groups (all P < 0.01) , and natural log-transformed NT-proBNP values increased in proportion with age for both genders and there was a lineal correlation between natural log-transformed NT-proBNP values and age (all P < 0.01) . Quantile regression derived normal reference values for NT-proBNP in male were 4.5-86.8 ng/L in the 40-44 years old group, 5.4-108.5 ng/L in the 45-49 years old group, 6.6-135.5 ng/L in the 50-54 years old group, 7.9-169.4 ng/L in the 55-59 years old group, 9.6-211.7 ng/L in the 60-64 years old group, 11.7-264.6 ng/L in the 65-69 years old group, 14.2-330.7 ng/L in the 70-74 years old group, and 18.1-429.2 ng/L in the ≥ 75 years old group. The reference values in female for NT-pro-BNP in respective age group were 8.5-141.8 ng/L, 10.4-166.6 ng/L, 12.8-195.7 ng/L, 15.7-229.9 ng/L, 19.3-270.1 ng/L, 23.7-317.3 ng/L, 29.1-372.8 ng/L, and 35.7-451.9 ng/L.</p><p><b>CONCLUSION</b>This study preliminarily establishes the normal ranges of plasma NT-proBNP in middle-aged and elderly ( ≥ 40 years) Chinese.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Asian People , China , Natriuretic Peptide, Brain , Blood , Peptide Fragments , Blood , Reference Values , Regression AnalysisABSTRACT
Objective To compare the dosimetric differences between two plans of RapidArc and 5F-IMRT for breast cancer radiotherapy after breast-conserving surgery.Methods Eight female patients with left-sided breast cancer after breast-conserving surgery were selected.A dose of 50 Gy in 25 fractions was prescribed for plans of RapidArc and 5F-IMRT.Target conformity index (CI),homogeneity index (HI),target coverage,exposure dose volume delivered to organ at risk were compared between two plans.At the same time,treatment delivery time and monitor units (MU) were also compared.Results The target conformity index (CI) in RapidArc plan (·0.88 ±0.03) was higher than that in 5F-IMRT plan (0.79 ±0.02,t =8.28,P ＜ 0.05).The homogeneity index (HI) in RapidArc plan 9.01 ± 0.73 was significantly lower than that in 5F-IMRT plan10.44 ± 1.08 (t =-2.73,P ＜0.05).For the dose volume delivered to the ipsilateral lung in two plans,the values of V10,V20,V30,and Dmean in RapidArc plan were lower than those in 5F-IMRT plan(t =-7.53,-7.20,-8.39,-7.80,P ＜ 0.05).However,the value of V5 in RapidArc plan was higher than that in 5F-IMRT plan (t =5.67,P ＜0.05).For the heart,the values of V5,V10 and Dmean in RapidArc plan were higher than those in IMRT plan(t =10.46,28.76,5.40,P ＜ 0.05),while the value of V30 in RapidArc plan was lower than that in 5F-IMRT plan(t =-6.12,P ＜0.05).The values of V5 in contralateral lung and breast were higher in RapidArc plan than those in 5F-IMRT plan(lung:t =21.50,P ＜0.05;breast:t =5.44,P ＜0.05).The MU in RapidArc plan was decreased by 25％,and the average treatment delivery time was saved by 60％,compared with that of 5F-IMRT plan.Conclusions During breast cancer radiotherapy after breast-conserving surgery,compared with 5F-IMRT plan,the RapidArc plan could improve the target HI,and reduce both the irradiated dose in high-dose volume and MU,and shorten the treatment time,but increased the exposed volume in low-dose volume of normal tissues.
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ObjectiveTo compare the accuracy of enhanced dynamic wedge (EDW) models of adaptive convolution algorithm (ACA) in Pinnacle3 9.0 and anisotropic analytical algorithm (AAA),and pencil beam convolution (PBC) algorithms in Eclipse7.3 treatment planning systems (TPS).MethodsTo evaluate the accuracy of the three algorithm models,we compared actual measurement values with TPS calculation values of EDW wedge factors under for different fields in which Varian-21EX 6 MV X-ray was applied,and also compared the actual dose distribution profile with that of TPS.ResultsThe deviations of EDW wedge factors of symmetry fields and asymmetric fields are within 2.8％ and 19.4％ for ACA in Pinnacle3 9.0.Meanwhile,the deviations are 1.0％ and 2.0％ for AAA,1.2％ and 3.0％ for PBC in Eclipse7.3.The deviations between measurement and calculation of all fields profile for ACA is within 3％ and within 2.7％ for AAA within 4.0％ for PBC in wedge direction.For the dose distributions,we evaluated the pass rates of three algorithms using gamma analysis.The gamma pass rates among all the three algorithms in symmetry and asymmetric fields are above 87％ and 85％ respectively.After the removal of the penumbra zone,the pass rates among all the three algorithms are above 96％ in symmetry fields,and above 95％ in asymmetric fields,respectively.Conclusions AAA and PBC algorithms in symmetric and asymmetric fields can meet the need of clinical applications.While,wedge factor of ACA should not be used in clinical due to its greater error in asymmetric fields.