Research of effect of cavity between bolus and skin on dose deposition in shallow tissues / 中华放射肿瘤学杂志

Objective To evaluate the effect of the thickness and area of the cavity between bolus and skin upon the dose deposition in the shallow tissues.Methods The linear accelerator head model of 6 MV X ray was constructed using Geant4,which simulated the accelerator working condition of 10 cm× 10 cm field and recorded the information of emergent particles as phase space file.A water phantom of 30 × 30 × 30 cm3 was designed at the SAD level.A 30 cm × 30 cm × 1 cm water film was constructed adjacent to or with different cavities to the upper surface of the phantom.The phase space file was utilized as particle source to simulate the particle transport process.The axis depth dose distribution and lateral dose profiles in the center area of the field at a depth of 1 mm,5 mm,9 mm,15 mm and 21 mm of the phantom were obtained,respectively.The simulated data obtained from water film with different cavities were compared with those of adjacent to the water phantom.Results When the cavity was ≤ 5 mm,the cavity exerted slight effect.When the thickness was increased,the maximum dose depth (Dmax) was increased,the PDD at Dmax (PD Dmax) became less,the depth of influenced lateral dose profiles was increased and the dose in the center area was decreased.Along with the increase of cavity area,the Dmax was initially increased and then decreased,the PD Dmax was at first decreased and subsequently increased,the depth of influenced lateral dose profile was initially increased and then decreased,the dose in the center area was first decreased and subsequently increased.The lateral dose profile distant from the cavity or located at a depth ≥ 15 mm was almost not affected by the cavity.Conclusion The thickness of the cavity between bolus and skin should be less than 5 mm and the cavity area should be small as possible.

Effect of cavity under bolus on the dose of superficial tissue / 中华放射肿瘤学杂志

Objective To investigate the effect of cavity thickness, area and distance under the bolus upon the dose in the superficial tissues. Methods An accelerator model was constructed based on Geant4.The model accuracy was validated by the comparison of the calculated data with the measured data. A 30×30×30 cm3 water phantom with the upper surface located at the isocenter level and a 30×30×1 cm3 water film were constructed. Different models with the water film close to or different cavities with the water phantom were established. Under the 10×10 cm2 field with 6 MV X-ray beam,the central axis depth dose distribution and the lateral dose profiles at a depth of 0. 1 cm ( profile1) of the models with different cavities were calculated. The calculated data of different model with the water film close to or different cavities with the water phantom were statistically compared. Results When the cavity thickness was ≤ 0. 5 cm, the cavity exerted slight effect upon the depth of maximum dose ( Dmax ) and superficial dose. As the cavity thickness was increased,the Dmax was also increased,the PDD at 0. 1 cm ( PDD1) was decreased rapidly and the profile1 was increased from the cavity center to the edge. Along with the increase of cavity area,the Dmax was initially increased and then decreased,whereas the PDD1 was first decreased followed by an increase. When the cavity area was small,the profile1 was gradually increased from the cavity center to the edge. When the cavity area was large,the profile1 was initially decreased and subsequently increased. When the distance was ≥0. 2 cm,it was qualified for the clinical requirement and it exerted no effect when the distance was≥1. 0 cm. The profile1 distant from the cavity was not affected. Conclusion The cavity under the bolus should be minimized to reduce the cavity thickness,area and distance as possible.

Relationship between sleep status and the risk of diabetes in adults / 中华流行病学杂志

Objective To explore the relationship between sleep status and the risk of diabetes in adults.Methods The baseline data of 53 260 subjects who were aged 30-79 years and had been enrolled into China Kadoorie Biobank (CKB) study from Suzhou,Jiangsu province were analyzed.Multiple logistic regression models were used to investigate the association between sleep status and diabetes after adjusting for potential confounders.Results Among 53 260 subjects,5.3％ had diabetes.The proportions of difficultly falling asleep,early morning arousal and snoring frequently was 7.2％,10.0％ and 29.5％,respectively.There were 22.6％ of subjects reporting sleep duration ≤6 hours.After controlling for possible confounders,the subjects with difficulty falling sleep (OR=1.63 for male,95％ CI:1.30-2.05;OR=1.48 for female,95％ CI:1.27-1.73),early morning arousal (OR=1.37 for male,95％CI:1.12-1.68;OR=1.31 for female,95％CI:1.14-1.51) or snoring frequently (OR=1.16 for male,95％CI:1.00-1.34;OR=1.39 for female,95％CI:1.23-1.57) had a higher risk of diabetes.Using hypnotics regularly was associated with the risk of diabetes in females (OR=1.42,95％CI:1.06-1.92).Compared with 8 hours sleep duration daily,shorter sleep duration (≤ 6 hours) was associated with risk of diabetes in both males (OR=1.37,95％CI:1.17-1.60) and females (OR=1.24,95％ CI:1.08-1.41).No statistical significant association was found between longer sleep duration (≥9 hours) and the risk of diabetes.Conclusion Sleep problems,including difficulty falling asleep,early morning arousal,snoring frequently and shorter sleep duration,were associated with the risk of diabetes,but no statistical significant association was observed between longer sleep duration and the risk of diabetes.

Analysis on the clinical effect of Yangxue Zhitong pills combined with Shuangbaisan on the treatment of children with hip synovitis / 中国生化药物杂志

To observe the clinical effect of Yangxue Zhitong pills combined with Shuangbaisan on the treatment of children with hip synovitis in.Methods 60 children with hip synovitis from November 2013 to May 2015 were randomly divided into the observation group and the control group,30 cases in each group.The observation group were given conventional treatment and the control group was given Yangxuezhitong pills combined with Shuangbaisan.Hip VAS and blood flow index in the two groups were followed-up and compared.Results (5 days after treatment,hip VAS in the observation group(3.50±0.46),was lower than that of the control group(4.51±0.55)(P<0.05).②CRP,TNF-α,IL-6,IL-1 level in the observation group were(3.01±1.73mg/L,15.58±5.46pg/mlL,74.9±19.4pg/mL,22.57±4.01ng/L),which were lower than those in the control group(5.69±2.05mg/L,32.47±4.16pg/mL,97.6±24.2pg/mL,32.17±4.38ng/L)(P<0.05).③After treatment,total effective rate in the observation group(93.3％)was higher than that in the control group 66.7％(P<0.05).Conclusion The clinical therapeutic effect of Yangxue Zhitong pill combined with Shuangbaisan on the treatment of children with hip synovitis is exact,which is worthy of further clinical research and application.

Relationship between sleep status and the risk of diabetes in adults / 中华流行病学杂志

Objective To explore the relationship between sleep status and the risk of diabetes in adults.Methods The baseline data of 53 260 subjects who were aged 30-79 years and had been enrolled into China Kadoorie Biobank (CKB) study from Suzhou,Jiangsu province were analyzed.Multiple logistic regression models were used to investigate the association between sleep status and diabetes after adjusting for potential confounders.Results Among 53 260 subjects,5.3％ had diabetes.The proportions of difficultly falling asleep,early morning arousal and snoring frequently was 7.2％,10.0％ and 29.5％,respectively.There were 22.6％ of subjects reporting sleep duration ≤6 hours.After controlling for possible confounders,the subjects with difficulty falling sleep (OR=1.63 for male,95％ CI:1.30-2.05;OR=1.48 for female,95％ CI:1.27-1.73),early morning arousal (OR=1.37 for male,95％CI:1.12-1.68;OR=1.31 for female,95％CI:1.14-1.51) or snoring frequently (OR=1.16 for male,95％CI:1.00-1.34;OR=1.39 for female,95％CI:1.23-1.57) had a higher risk of diabetes.Using hypnotics regularly was associated with the risk of diabetes in females (OR=1.42,95％CI:1.06-1.92).Compared with 8 hours sleep duration daily,shorter sleep duration (≤ 6 hours) was associated with risk of diabetes in both males (OR=1.37,95％CI:1.17-1.60) and females (OR=1.24,95％ CI:1.08-1.41).No statistical significant association was found between longer sleep duration (≥9 hours) and the risk of diabetes.Conclusion Sleep problems,including difficulty falling asleep,early morning arousal,snoring frequently and shorter sleep duration,were associated with the risk of diabetes,but no statistical significant association was observed between longer sleep duration and the risk of diabetes.

Intra-operative radiotherapy in breast-conserving surgery of early breast cancer patients / 中华普通外科杂志

Objective To evaluate intra-operative radiotherapy after breast conservative surgery in early breast cancer patients in terms of postoperative complications,cosmetic outcome and recurrence events.Methods From June 2007 to Dec 2010,115 early breast cancer patients received breast conserving surgery.Fifty-nine patients (study group) received intra-operative radiotherapy,compared with 56 patients (control group) receiving routine postoperative radiotherapy.Postoperative complications were evaluated 1 month after surgery; cosmetic outcome was evaluated 1 year postoperatively; recurrence and death events were followed up.Results The average wound healing time was 13 -22 days in study group and 9 - 14days in control group.In the study group,2 patients developed fat deliquescence,16 patients showed wound edema while no such side effects were found in control group.No infection or hematoma were found in either group.Overall cosmetic outcome was rated 1 year post operation.In the study group (41 cases),36 patients were graded as excellent or good,5 patients were as fair or poor.Meanwhile in the control group (37 cases),wounds in 25 patients were graded as excellent or good,that in 12 patients were as fair or poor (P =0.031).After a follow-up from 3 to 42 months(median:24 months),two patients (3.39％) in study group developed local cancer relapses,one of them( 1.7％ ) died.In control group,one patient ( 1.8％ )developed local relapse,and no one died.Conclusions Intra-operative radiotherapy is safe and reliable with good cosmetic outcome.

Clinical application of the Contoura carbon fiber belly board in patients with rectal cancer undergoing postoperative radiotherapy / 肿瘤

Objective:To evaluate the protection of small bowel and bladder by Contoura carbon fiber belly board in patients with rectal cancer undergoing postoperative radiotherapy and the position deviation during radiotherapy. Methods: This study enrolled 45 consecutive patients with rectal cancer who had undergone prior surgery. Twenty patients who applied the belly board were defined as group A, and the other 25 patients were defined as group B. All the patients received threE-dimensional conformal radiation therapy(3D-CRT), and the prescriptive radiation dosage of 95% of planning target volume (PTV) was 50 Gy/25 times. Patients in group A underwent two sets of CT scans as follows: group A1, prone alone; group A2, prone with the use of the belly board. The radiation dosage and radiated volume in PTV, small bowel, and bladder were observed by dosE-volume histograms. Ten patients were selected randomly from group A and group B, respectively. Their position deviation during radiotherapy was measured by double exposure field verification system. The acute radiation reactions of all patients were observed and recorded during radiotherapy. Results: No significant difference was found in the total PTV and total volume of small bowel and bladder and mean irradiation dosage to PTV between groups A1 and A2. The mean irradiation dosage to the small bowel and bladder, the volume of small bowel irradiated at 10%-100% dose levels, and the volume of bladder irradiated at 30%-100% dose levels, were significantly decreased in group A2. The difference was significant. Compared with group B, the right-left and superior-inferior position deviations were significantly reduced in group A. The difference was significant (P<0.05). The anterior-posterior position deviation was also reduced, but the difference was not significant (P=0.705). The incidence of grade 3 or more adverse reactions were 15% (3/20) in group A and no patient broke off or stopped treatment; the incidence of grade 3 or more adverse reactions was 24% (6/25) in group B, and two patients broke off the treatment because of severe adverse reaction. One patient terminated the treatment. Conclusions: The Contoura carbon fiber belly board can reduce the irradiation dosage and volume of small bowel and bladder in patients with rectal cancer undergoing postoperative radiotherapy. The position deviation has better reproducibility and the acute radiation reactions are tolerable. It is worthy of application in clinic.