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Objective To analyze the dosimetric features of chest wall radiotherapy after modified radical mastectomy for left breast cancer using the beam’s eye view (BEV) in intensity-modulated radiation therapy (B-IMRT). Methods A total of 13 patients treated with modified radical mastectomy for left breast cancer in the Liaocheng People’s Hospital from May 2020 to November 2020 were recruited. They were treated with postoperative radiotherapy using the plans of B-IMRT or tangential fields in intensity-modulated radiation therapy (T-IMRT). The mean dose, conformity index and homogeneity index of the target field, and dose volume parameters of left lung and heart were compared between two groups. Results Compared with those of T-IMRT group, B-IMRT significantly improved the conformity and homogeneity of the target field (P < 0.05), and their mean dose of target field was similar. In addition, V5, V10, V20, V30 and Dmean of the left-side lung, and V5, V10, V30 and Dmean of the heart in B-IMRT group were significantly reduced compared with those of T-IMRT group (P < 0.05). In comparison to those of T-IMRT, B-IMRT decreases V5, V10, V20, V30 and Dmean of the left-side lung by 9.23%, 13.29%, 9.54%, 8.28% and 10.35%, respectively, which decreases V5, V10, V30 and Dmean of the heart by 27.62%, 29.72%, 21.45% and 24.88%, respectively. Conclusion Compared with T-IMRT planning, B-IMRT presents dosimetric advantages in the conformity and homogeneity of the target field in the postoperative radiotherapy of patients treated with modified radical mastectomy for left breast cancer, especially in reducing the radiation dose and volume of the heart and lungs.
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Objective To investigate the correlation between type H hypertension and the development of coronary atherosclerosis.Methods From January 2015 to December 2016,three hundred and sixty patients with essential hypertension complicated with coronary atherosclerosis were treated in First Hospital of Shijiazhuang were selected,according to the level of serum homocysteine (Hcy),the patients were divided into the observation group (n =197 cases,Hcy ≥ 10 μ mol/L) and the control group (n =163 cases,Hcy＜10 μmol/L),all patients underwent coronary angiography and intravascular ultrasound.Results The cross-sectional area of extravascular elastic membrane (EEMCSA),plaque area (PA) and plaque burden(PB) of the observed group were (15.10±0.91) mm2,(8.80±0.99) mm2 and (62.03±3.20)％,wrere obviously higher than thoseat of the control group((13.72±0.96) mm2、(7.92±0.89) mm2、(56.87 ±3.37) ％),and the difference was statistically significant (t =14.079,、8.864,and 14.983,P＜0.05),and the minimum lumen cross section area (MLA) was (5.40 ±0.64) mm2,were obviously lower than that of the control group ((5.89 ± 0.52) mm2),and the difference was statistically significant (t =-7.937,P＜0.05);The Gensini score of the coronary artery in the observation group was (67.64± 13.19) points,which was significantly higher than that in the control group ((55.34± 12.20) points),and the difference was statistically significant (t =9.190,P＜0.05);the Serum Hcy were positively correlated with PA,PB and Gensini scores in the observation group (r =0.873,0.732and 0.856,P ＜ 0.05),which was negatively correlated with MLA (r =-0.773,P＜0.05).Conclusion There is a certain correlation between the severity of coronary atherosclerosis and the level of serum Hcy in patients with type H hypertension,which is worthy of further study.
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BACKGROUND:In total hip arthroplasty, the accurate placement of the acetabulum is needed to guarantee the survival rate of the prosthesis and improve the prognosis. In order to ensure the accurate placement of the acetabulum, the accurate measurement of the abduction angle and the anteversion angle of the acetabulum is needed. OBJECTIVE:To investigate the application value of C-arm X-ray displacement measurement of acetabular anteversion angle and abduction angle in total hip arthroplasty. METHODS:Total y 63 cases undergoing total hip arthroplasty were divided into two groups according to their wil . Patients in the control group (n=30) were implanted with traditional acetabular prosthesis locator. Patients in the observation group (n=33) were implanted with acetabular prosthesis after C-arm X-ray displacement measurement. Acetabular anteversion angle, abduction angle and pelvic inclination were measured before, during and after arthroplasty. Acetabular anteversion angle and abduction angle were measured in both groups after arthroplasty. Pain score and hip function Harris score were recorded in both groups at different time points. RESULTS AND CONCLUSION:(1) No significant difference in acetabular anteversion angle, abduction angle and pelvic inclination was detected before, during and after arthroplasty (al P>0.05). (2) No significant difference in abduction angle was determined between the two groups after arthroplasty (P>0.05), but acetabular anteversion angle was significantly smal er in the observation group than in the control group (P<0.05). (3) At 7 days after arthroplasty, Visual Analog Scale scores were less in the observation group than in the control group (P<0.05). (4) Compared with that before arthroplasty, Harris score was significantly higher after arthroplasty in both groups (P<0.05). Harris score was higher in the observation group than in the control group at 3 and 12 months after arthroplasty (P<0.05). (5) Results indicated that during total hip arthroplasty, C-arm X-ray machine can measure acetabular anteversion angle and abduction angle, and effectively correct pelvic inclination, internal and external rotation, abduction and adduction, improve the accuracy of acetabular cup placement and the quality of replacement surgery, and improve the prognosis of the patients.
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Objective To investigate the timing of surgical operation and prognosis of patients with severe biliary pancreatitis (SBP).Methods The patients were classified into three groups according to the interval between disease onset and operation time ( ＜7 d, 7 ～ 14 d, ＞ 14 d).The incidence of complications and mortality were compared among the 3 groups.Results A total of 32 patients of acute pancreatitis due to biliary tract diseases between 2006 and 2009 were included, and there were 15 males and 17 females with a median age of 51 years old.9 patients received operation within 7 days of disease onset and all of these patients were complicated with biliary obstruction;12 patients received operation between 7 ～ 14 days of disease onset and all of these patients were non-respondent to early non-operative management.11 patients received operation after 14 days.The complication rates in the three groups were 44.4% , 50.0% and 45.5%, respectively, the difference was not statistically significant ( P ＞ 0.05 ).The mortality rates in the three groups were 11.1%,16.7% and 18.2%, respectively, and the difference was not statistically significant ( P ＞ 0.05 ).Conclusions The management of SBP should be individualized.Patients with biliary obstruction, suppurative cholangitis or non-respondent to early non-operative management shall be managed surgically, and this is critical to decrease the mortality rates and improve prognosis.