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Objective:Patients are breathing freely during adjuvant proton pencil beam radiotherapy after breast conserving surgery. Fluctuation of the thorax may affect the position of the end of the proton beam flow, which needs to be precisely evaluated on a millimeter scale.Methods:For 20 patients with breast cancer treated with proton radiotherapy after breast conserving surgery, PET-CT scan was performed approximately 10 min after the end of proton radiotherapy. The images of PET-CT were processed for ROI determination and sampling line (profile) extraction on a Raystation RV workstation to calculate the actual difference between the predicted and real radioactivity from the same spatial location as obtained by PET acquisition R50. Then, the differences in the spatial location between the actual process of proton irradiation and the planned process were obtained. Depth difference values for each pair of sampling lines were presented. Results:For 20 patients with breast cancer with a median follow-up of 22 months (range 12 - 46 months), all patients survived at the last follow-up, and no radiation pneumonitis was observed during the follow-up period. Among the verification results of 21 cases, the depth difference of evenly distributed was (-0.75±1.89) mm in the primary field and (-0.82±2.06) mm in the secondary field; The depth difference of sequential treatment was (1.81±1.87) mm in the primary field and (1.32±1.74) mm in the secondary field; The depth difference of synchronous addition in the primary field was (-1.47±1.44) mm, and the depth difference in the secondary field was (-1.48±2.11) mm.Conclusion:The results of off-line PET-CT in vivo biological verification show that the accuracy of the dose boundary cut-off was within 3 mm in breast cancer patients, which meets the clinical and physician requirement for the precision in breast cancer treatment.
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After the promulgation and implementation of the Vaccine Administration Law of the People’s Republic of China， the compensation of suspected adverse reactions in China is to be reformed and innovated. There have been attempts at compensation through government finance and insurance， but there has been no precedent for a fund of vaccine-related compensation in China， which means that this could be a new method of solving disputes of compensation for vaccine-related incidences and enhancing public confidence in vaccination. It is suggested that under the current system， we can select a province as a pilot to explore the fund compensation mechanism. The fund comes from special financial allocation， special taxation of vaccine enterprises， fund investment income， charitable donation and other channels. Through a special fund management organization， the independent identification and compensation process can be realized， so as to shorten the current compensation procedure， improve the amount of compensation， ultimately protect the interests of all parties， and promote the steady development of vaccination.
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Objective@#To investigate the effect of lipiodol as embolization agents in liver, after transcatheter arterial chemoembolization, on dose calculation under the carbon ion treatment plan.@*Methods@#The actual relative linear stopping powers(RLSP)in pure lipiodol, pure gel and lipiodol-gel mixture, together with the correctd RLSPs from their CT images, were compared.In seven typical cases with lipiodol deposition area, carbon ion treatment plan was performed for the original lipiodol images.Successively on the basis of analysis that has made, the RLSP in lipiodol deposition area was corrected to be as in normal liver tissue, for which the carbon ion treatment plan was again performed.A comparison was made of differences in water equivalent depth (WED) and dose distribution on different CT images.@*Results@#The RLSP value corrected according to CT image HU value, lipiodol, and lipiodol-gel mixture may increase by 4.6%-139.0% compared with the measured value. In seven typical cases, deposited lipiodol can cause WED to increase by (0.89±0.41) cm along the field track and RBE by(3.83±1.71)Gy within the 1 cm of distal area of target.@*Conclusions@#In order to improve the accuracy of dose distribution calculation, the HU value and/or RLSP in deposited lipiodol area in liver after transcatheter arterial chemoembolization should being corrected to be as in the normal liver tissue.
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Objective@#To learn the characteristics of gastric cancer incidence and mortality in Lishui from 2014 to 2018，and to provide basis for prevention and control strategies for gastric cancer. @*Methods@#The data of gastric cancer in Lishui from 2014 to 2018 was collected from Zhejiang Chronic Disease Surveillance Information Management System. The incidence and mortality rates of gastric cancer were calculated，and the trend of them was evaluated by annual percentage change（APC）.@*Results@#The crude incidence rate of gastric cancer in Lishui was 44.77/100 000（5 650 cases）and the standardized one was 26.93/100 000. From 2014 to 2018，the incidence rates of gastric cancer showed a decreasing trend（APC=-0.79%，P<0.05）. The crude mortality rate of gastric cancer in Lishui was 25.39/100 000（3 205 cases）and the standardized one was 14.21/100 000. From 2014 to 2018，the mortality rates of gastric cancer were stable（APC=-4.61%，P>0.05）. The standardized incidence and mortality rates of gastric cancer in males were 34.77/100 000 and 18.35/100 000，which were higher than 16.77/100 000 and 8.52/100 000 in females（P<0.05）. The standardized incidence and mortality rates of gastric cancer in rural residents were 46.07/100 000 and 26.11/100 000，which were higher than 38.49/100 000 and 22.02/100 000 in urban residents. The incidence and mortality rates increased with age after 15 years old，and reached the peak at the age group of 80-84 years old.@*Conclusion@#The incidence and mortality of gastric cancer in Lishui from 2014 to 2018 were at a high level，which were higher in males than in females and were higher in rural than in urban areas；while the incidence had a downward trend.
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Objective To understand the status of health literacy among residents in Lishui City,and to analyze its influencing factors. Methods Multistage stratified cluster sampling was used to recruit 2 813 residents aged 15 to 69 years old. Influencing factors of health literacy were also analyzed by logistic regression. Results A total of 2 071 valid questionnaires were collected. The general health literacy rate among residents was 15. 25%,and the standardized rate was 16. 26%. The proportion of residents with basic knowledge and health concept,healthy lifestyle and behavior and health related skills were 19. 33%,8. 63% and 22. 99% respectively. The proportion of scientific view,prevention of infectious disease,prevention of chronic disease,safety and emergency treatment,acquisition of basic health care and information were 42. 69%, 29. 43%, 9. 11%, 53. 31%, 18. 29% and 24. 81% respectively. Logistic regression showed that education,occupation and income were the influencing factors of health literacy. Conclusion It is important to improve the health literacy of residents in Lishui City. Education,occupation and income were associated with health literacy.