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Objective To evaluate the clinical efficacy and safety of simultaneous enhanced accelerated radiation therapy for brain metastases (SMART-Brain) combined with functional area protection. Methods SMART-Brain was planned for 60 patients with multiple brain metastases. Using the whole brain intensity modulation technique, important functional areas such as hippocampus were protected against irradiation by delivering a dose of 30 Gy in 10 fractions. Meanwhile, a high dose of 40 Gy was delivered to brain metastases in 10 fractions. All patients were followed up to evaluate the efficacy, incidence of adverse reactions, median overall survival (OS), and intracranial progression-free survival (IPFS). Results The effective rate was 73.33% (44 cases), the disease control rate was 91.67% (55 cases), median OS was 15.2 months, and IPFS was 12 months. The 1 and 2-year OS was 66.7% and 26.4%, and the 1-year IPFS was 46.7%. The MMSE scores at 1, 3, and 6 months after SMART showed no significant differences compared with baseline scores (P > 0.05). Grade 2 and above inner ear damage such as otitis media, hearing loss, and dizziness was absent. Conclusion Smart-Brain can significantly reduce the treatment time and better protect the organs at risk, and serves as an economical, safe, and effective radiotherapy regimen in areas with limited technical conditions.
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Objective To compare the dosimetric characteristics of non-coplanar and coplanar field technology in static intensity-modulated radiotherapy of gastric cancer patients, so as to provide a reference for clinical radiotherapy plan selection. Methods Thirty-six patients with gastric cancer were selected to receive intensity-modulated radiotherapy in Huanggang Central Hospital, which was designed plan A and B. Group A used 7-field coplanar technology, while Group B used 7-field non-coplanar technology. We compared the differences of the optimized monitor unit, the dosimetry of organs at risk and target areas between group A and group B. Results Both group A and B could meet the requirements of doctors. The homogeneity index (0.14 ± 0.02), the conformity index (0.98 ± 0.01), Dmin (4315.21 ± 16.74) cGy、Dmean (4679.28 ± 28.39) cGy and Dmax(4952.30 ± 33.26) cGy of target areas in group B were better than those of group A. Moreover, the monitor unit of group B was much lower than that of group A, and the difference was statistically significant (P < 0.05). The Dmax, Dmean, V15, V20 and V30 of the left and right kidneys in group B were lower than those of group A. The Dmax (3408.57 ± 46.03) cGy, Dmean (1250.32 ± 14.27) cGy and V20 (44.91% ± 6.67%) of spinal cord and the Dmax (3408.57 ± 46.03) cGy, Dmean (1720.55 ± 17.42) cGy, V20 (25.31% ± 7.78%) and V30 (18.52% ± 1.56%) of small intestine were also lower than those of group A. The differences were statistically significant (P < 0.05). Conclusion The non-coplanar field radiation plan has more advantages in terms of target dose distribution and protection of organs so that it can be more considerably used in the process of planning and design.
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Objective To investigate the lamina windowing small gap and the vertebrae pedicle bone graft in the treatment of thoracolumbar burst fractures of the curative effect.Methods 132 patients with thoracolumbar burst fracture of were selecteds, the average random divided into open the window and pedicle group, open a window line set of lamina windowing small gap vertebral body bone graft and pedicle group through pedicle vertebral body bone graft, through intraoperative records, hospital records and postoperative follow-up of collecting morphological index, operation index, JOA score and Frankel classification of spinal cord injury in order to evaluate the clinical curative effect of two kinds of operative methods.Results The operation time in the pedicle group was (103.58±14.37) min, which was more than that of the fenestration group [ (85.72±12.96) min], the incision drainage rate in the pedicle group [ (100.96±5.29) ml] was less than that in the fenestration group [ (178.52±12.41) ml], and the postoperative pain score in the pedicle group [ (15.37±2.86) ] was higher than that in the fenestration group [ (8.26±4.52) ], the healing time of fractures in the pedicle group [ (20.85±0.60) weeks ]was less than that of the fenestration group [ (24.29±1.06) weeks].The difference was all statistically significant (P＜0.05).After treatment, the intervertebral space height of the pedicle group [ (11.55±1.94) mm] was significantly higher than that of the fenestration group [ (9.53±1.92) mm], and the difference was statistically significant (P＜0.05).After treatment, the JOA scores of patients in the pedicle group[7.78±1.39, 4.93±0.92, 13.84±2.74] were significantly higher than those in the open window group[6.24±1.20, 4.50±0.83, 12.43±2.52] (P＜0.05).The difference between the composition of Frankel spinal cord injury in the pedicle group and the fenestration group was statistically significant (P＜0.05).Conclusion Compared with small fenestration through the intervertebral space, this surgical method can promote the fracture healing and improve the symptoms of patients more rapidly, and is more suitable for the surgical treatment of thoracolumbar burst fracture patients.
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The proliferation of splenic lymphocytes, the humoral immune response to sheep red blood cells and the phagocytotic function of intraperitoneal macrophages of mice were all stimulated by ig the flesh of Meretrix meretrixL. (FM) 20 g/kg and 10 g/kg for 7 days. FM 20 g/kg and 10 g/kg ig for 15 days also enhanced the activity of serum T-SOD, and decreased the level of serum MDA in old mice. The anti -stress effect of FM, such as increasing the swimming time of mice in 20癈 water by ig FM 20 g/kg and 10 g/kg for 7 days, was also achieved.