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Objective:To study the differences in the cumulative dose between deformable image registration (DIR) and simple dose-volume histogram (DVH) summation in the fractionated brachytherapy of cervical cancer, and to analyze the feasibility of the application of DIR in the dosimetry assessment of targets and organs-at-risk (OARs) in the brachytherapy.Methods:A retrospective analysis was conducted for 13 cases with primary cervical cancer treated with four fractions of interstitial brachytherapy guided by CT images. The four CT images of each cases were registered using an intensity-based DIR. Then, the cumulative doses (the D2 cm 3, D1 cm 3, and D0.1 cm 3 of the bladder, rectum, intestine, and colon and the D90for targets) after DIR were calculated and compared to those obtained using simple DVH summation. Afterward, the correlation between the dose difference and dice similarity coefficient (DSC) was analyzed. With the dose difference (the remaining dose of OARs caused by the DIR) as limits, a new plan was made for the latest CT to calculate the dose increase to targets. Results:Compared to simple DVH summation, DIR allowed the cumulative doses of the D2 cm 3 and D1 cm 3 of bladder to be decreased by (2.47±1.92) and (2.82±2.73) Gy, respectively on average ( t=-3.65, -2.93, P < 0.05), those of the D2 cm 3, D1 cm 3, and D0.1 cm 3 of rectum to be decreased by (2.05 ± 1.61) Gy, (1.51 ± 1.58), and (3.21 ± 2.50) Gy, respectively on average ( t=-4.02, -3.02, -4.06, P < 0.05), and those of the D2 cm 3, D1 cm 3, and D0.1 cm 3 to be decreased by (1.42 ± 0.99), (1.55 ± 1.28) Gy, and (2.43 ± 1.95) Gy, respectively on average ( t=-3.52, -2.96, -3.06, P < 0.05). There was no significant statistical difference in the D90 of targets, the D0.1 cm 3 of the bladder, and the D2 cm 3, D1 cm 3, D0.1 cm 3 of the colon ( P > 0.05) between both methods, and there was no distinct correlation between DSC and dose difference ( P > 0.05). The DIR increased the dose to targets, with a median value of 150 cGy. However, the accuracy of the DIR should be improved. Conclusions:In clinical practice of multiple fractions of brachytherapy for cervical cancer, it′s still recommended to adopt the simple dose summation method to assess the doses to targets and OARs.
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Objective:To establish a dosimetric method based on the well-chamber to verify the accuracy of the source positioning and dwelling time for the afterloading machine, aiming to provide a new method for the quality control of afterloading machine.Methods:The principle of this method was explained according to the hardware structure of the well-chamber. Then, the precision of this method was analyzed by the simulation test and data fitting. The feasibility test was also performed. And the advantages and disadvantages of this method were compared with those of the traditional method.Results:The precision of this method for detecting the source positioning was 0.07 mm and the dwelling time was 0.09 s, respectively. In the feasibility test, the standard deviation of the measure value was below 3%.Conclusions:The well-chamber method has high precision and convenient operation. It can be applied in the rapid verification of the relative accuracy of the source positioning and dwelling time of well-chamber.
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@#To investigate the clinical features and influencing factors for new-onset atrial fibrillation (AF) early after coronary artery bypass grafting. Methods The clinical data of 339 patients undergoing coronary artery bypass grafting in our hospital from January 2012 to January 2019 were retrospectively analyzed. There were 267 males and 72 females with an average age of 37-83 (58.03±8.90) years. The clinical features and influencing factors for new-onset AF after surgery were investigated. Results There were 234 patients of off-pump coronary artery bypass grafting (OPCABG), with 36 (15.4%) new-onset AF patients after operation, among whom 16.1% were males and 12.5% were females. There were 105 patients of on-pump coronary artery bypass grafting (CABG), with 39 (37.1%) new-onset AF patients, among whom 40.7% were males and 25.0% were females. The incidence was higher after the CABG surgery than that after the OPCABG surgery (37.1% vs. 15.4%, P<0.05). There was no statistical difference in the incidence rate between males and females (P>0.05). The incidence of new-onset AF after surgery was higher in ≥60 years patients for both operations (18.9% and 45.8%), which was significantly higher than that in <45 years patients (P<0.05). For both operations, the incidence of new-onset AF after surgery was high on the second day (24-48 h) after surgery, and most of the AF lasted for 1 day (P<0.05). The hypertension (OR=4.983, P=0.036), frequent premature atrial contraction or atrial tachycardia (OR=17.682, P=0.002), postoperative creatine kinase isoenzyme MB (CKMB) (OR=0.152, P=0.042), left anterior and posterior diameters (OR=17.614, P<0.001) and preoperative ejection fraction (OR=7.094, P=0.011) were influencing factors for new-onset AF after OPCABG. Diabetes (OR=11.631, P=0.020), other cardiac malformations (OR=29.023, P=0.002), frequent premature ventricular contraction or ventricular tachycardia (OR=0.047, P=0.001), and postoperative CKMB (OR=3.672, P=0.040) were influencing factors for new-onset AF after CABG. Conclusion The incidence of new-onset AF after CABG is higher than that after OPCABG, and it increases with age increasing. There is no difference in the incidence between males and females. The influencing factors for the two operations are different.
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Objective@#To study the feasibility of using the PTW729 2D array ion-chamber to verify the relative dose distribution calculated with the Acuros BV algorithm. Both advantages and disadvantages of the method were analyzed to provide reference for practical clinical practices.@*Methods@#Based on self-built measurement phantoms, the dose distribution on the same slice of the phantom was measured with PTW729 and film, respectively, under the same measurement condition and plan. The dose distributions obtained by the two method were compared with the result calculated with Acuros BV, separately, by using γ analytical tool. And the stability of the PTW729 was tested.@*Results@#The γ comparison value was 95.9% between the film and Acuros BV, 98.9% between the PTW729 and Acuros BV and 88.0% between the film and PTW729, with 95.0%, 100.0%, and 100.0%, in their stability test respectively.@*Conclusions@#PTW729 2D array ion-chamber can be applied to the rapid verification of Acuros BV algorithm-calculated relative dose distribution.
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Objective To study the feasibility of using the PTW729 2D array ion-chamber to verify the relative dose distribution calculated with the Acuros BV algorithm.Both advantages and disadvantages of the method were analyzed to provide reference for practical clinical practices.Methods Based on self-built measurement phantoms,the dose distribution on the same slice of the phantom was measured with PTW729 and film,respectively,under the same measurement condition and plan.The dose distributions obtained by the two method were compared with the result calculated with Acuros BV,separately,by using γ analytical tool.And the stability of the PTW729 was tested.Results The γ comparison value was 95.9％ between the film and Acuros BV,98.9％ between the PTW729 and Acuros BV and 88.0％ between the film and PTW729,with 95.0％,i00.0％,and 100.0％,in their stability test respectively.Conclusions PTW729 2D array ion-chamber can be applied to the rapid verification of Acuros BV algorithm-calculated relative dose distribution.
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Objective:To analyze clinical outcomes of myocardial incision and tearing for the treatment of myocardial bridge.Methods:A retrospective cohort study was conduct to review the clinical date of 29 patients who underwent surgical myotomy from January 2014 to January 2018 in the Second Hospital of Lanzhou University. A total of 11 patients(incision group) were experienced traditional myotomy on myocardial bridge that the myocardium was longitudinally incised along the direction of the coronary artery, while 18 patients(tearing group) were treated by myocardial incision combined with tearing that longitudinally incised myocardium and deeply tissue tearing. The operation time of surgical myotomy, the amount of bleeding, the number of branches of vascular injury and the number of ventricular ruptures during operation were compared between the two groups. After followed up half a year to one year, the clinical symptoms of angina pectoris, myocardial ischemia by electrocardiogram suggested, and coronary stenosis by coronary CT suggested were collected.Results:The operation time of surgical myotomy, the amount of bleeding patients and the number of branches of vascular injury during operation in the incision group were higher than those in the tearing group( P<0.05). There was no significant difference for the number of ventricular ruptures during operation( P>0.05). After followed up half a year to one year, there was no significant difference in the clinical symptoms of angina pectoris, myocardial ischemia by electrocardiogram suggested, and coronary stenosis by coronary CT suggested( P>0.05). Conclusion:Myocardial incision combined with tearing is a surgical procedure with short operation time and low bleeding risk, which is more beneficial than the traditional longitudinally incised for the myocardial bridge.
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Objective:To explore the changes of blood viscosity in high-intensity alternating magnetic field and the mechanisms.Methods:Five adult sheep were randomly selected and the blood samples were placed in highintensity alternating magnetic field.Before and after exposure,the blood samples were taken and divided into 2 groups:a control group and a magnetic field group.The blood rheology and transmission electron microscopy (TEM) were performed.Results:Compared to the control group,the high shear viscosity of whole blood was decreased in the magnetic field group (P＜0.05);the whole blood low shear viscosity and plasma viscosity were also decreased (both P＜0.01).TEM showed the changes in red blood cell morphology and the double concave disc curvature.The radian of double concave disc and cell volume in the magnetic field group was larger than those in the control group.Conclusion:The high intensity alternating magnetic field may affect the distribution of surface charge and molecular current in blood cells,which in turn decrease the aggregation of cells and the blood viscosity.
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Objective To investigate the value of DWI imaging combined with T2WI imaging and CT image fusion technology and explore the role of DWI imaging in the determination of target areas in radiotherapy for advanced esophageal cancer.Methods Twenty-three patients with locally advanced esophageal cancer were included in this study.All the patients were fixed by a heat plastic device.Each patient was examined by CT,T2WI and DWI scan in the same position as the radiotherapy treatment.Images obtained from the three sequences were transmitted to the Eclipse 11.0 treatment planning system.All images were registered at Eclipse workstation as to normalized mutual information registration.The target areas were delineated by the clinical radiation physicians in the CT imaging,and CT and DWI fusion images.The target areas of the two kinds of image were evaluated using fusion function and statistical function of the treatment planning system.Results Target parameters differed significantly between CT base and CT/MRI fusion base.The results of the target volume outline closer by CT and MRI fusion image base in the three groups of clinicians.Conclusion The target volume between the groups is closer by using CT and DWI fusion image.DWI image has a good assisting effect in determining the target area of locally advanced esophageal cancer.
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ObjectiveTo investigate the clinical effect of ultrasound-guided percutaneous transhepatic gallbladder drainage (PTGD) in the treatment of acute cholecystitis in elderly patients. MethodsA retrospective analysis was performed for the clinical data of 62 patients who underwent PTGD in Nanjing Hospital Affiliated to Nanjing Medical University from June 2010 to June 2015. The body temperature, white blood cell(WBC) count, liver function, and gallbladder size were measured before PTGD and at 24 and 72 hours after PTGD. The paired t-test was used for comparison of continuous data before and after treatment within each group. ResultsAll the patients achieved a one-time success in PTGD. There was no significant change in body temperature at 24 hours after PTGD (t=0.91, P＞0.05). There were significant reductions in WBC count, alanine aminotransferase, and aspartate aminotransferase from 24 to 72 hours after PTGD, as well as a significant reduction in gallbladder size (all P＜0.05). ConclusionUltrasound-guided PTGD is a safe and effective minimally invasive method for the treatment of acute cholecystitis in critically ill elderly patients who are unable to undergo surgery.
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<p><b>OBJECTIVE</b>To determine the relationship between the serum sulfur dioxide, homocysteine and the pulmonary arterial pressure in children with congenital heart defects who generated a pulmonary arterial hypertension syndrome (PAH-CHD), and analyze their role in the pathological process of the disease.</p><p><b>METHOD</b>This was a prospective cohort study, children with systemic pulmonary shunt CHD were selected. The patients were divided into three groups: the CHD with no PAH group:n = 20, 10 males, 10 females, 5 with ventricular septal defect (VSD), 8 with atrial septal defect (ASD) and 7 with patent ductus arteriosus (PDA), mean age (1.9 ± 1.8) years; the CHD with mild PAH group:n = 20, 10 males, 10 females, 12 with VSD, 6 with ASD, and 2 with PDA, mean age (1.0 ± 0.8) year; the CHD with moderate or severe PAH group:n = 20, 8 males, 12 females, 12 with VSD, 6 with ASD, and 1 with PDA, 1 with ASD+VSD, mean age (1.8 ± 1.6) year. Twenty healthy children were enrolled from outpatient department as the control group [included 8 males, 12 females, mean age (1.9 ± 1.5) years]. The homocysteine and SO2 concentrations in the serum samples were detected by a modified high performance liquid chromatographic method with fluorescence detection (HPLC-FD), then, multiple comparisons among the groups were performed with analysis of variance, and the pearson correlation.</p><p><b>RESULT</b>The serum homocysteine concentrations were respectively (11.0 ± 2.7) , (11.7 ± 2.5), (12.0 ± 2.1), (14.3 ± 3.2) µmol/L in the control group, CHD with no PAH group, CHD with mild PAH group, and CHD with moderate or severe PAH group. According to the multiple comparisons, the CHD with moderate or severe PAH group had the highest level (P all < 0.05) .While the comparison within the control group, CHD with none PAH group, and CHD with mild PAH group, the differences were not significant (P all > 0.05). The serum sulfur dioxide strength (concentrated as SO3(2-)) were respectively (10.6 ± 2.4), (8.9 ± 2.3), (7.3 ± 2.9), (4.3 ± 2.1) µmol/L in the control group, CHD with none PAH group, CHD with mild PAH group, and CHD with moderate or severe PAH group. CHD with moderate or severe PAH group had the highest level of serum sulfur dioxide (P < 0.05) . The pearson correlation analysis indicated that in the CHD children, the serum homocysteine were positively correlated with the pulmonary arterial pressure (r = 0.481, P < 0.01), while, the sulfur dioxide were negatively correlated with pulmonary arterial pressure (r = -0.553, P < 0.01).In all children, the serum homocysteine levels were negatively correlated with the sulfur dioxide (r = -0.231, P = 0.039).</p><p><b>CONCLUSION</b>The PAH-CHD children had higher homocysteine levels and lower sulfur dioxide levelsl, which demonstrated the disturbance of homocysteine-sulfur dioxide pathway in the sulfur containing amino acids metabolish in the disease. The homocysteine may become a biological marker which reflecting the severities of the PAH-CHD, while the sulfur dioxide can be a new target for the therapy of PAH-CHD.</p>
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Child, Preschool , Female , Humans , Infant , Male , Biomarkers , Blood , Case-Control Studies , Ductus Arteriosus, Patent , Blood , Familial Primary Pulmonary Hypertension , Blood , Heart Defects, Congenital , Blood , Heart Septal Defects , Blood , Hemodynamics , Homocysteine , Blood , Sulfur Dioxide , BloodABSTRACT
BACKGROUND:Osteoarthritis animal models induced by papain are commonly used for studying osteoarthritis. OBJECTIVE:To observe the morphology of articular cartilage surface during early osteoarthritis process in rats induced by papain and L-cysteine under scanning electron microscope. METHODS:The right knees of Sprague-Dawley rats were given 0.15 mL mixed solution of 2%papain and 0.03 mol/L L-cysteine in the ratio of 2:1. The left knees were given injections of 0.15 mL 0.9%NaCl, as the control group. Another two rats (four knees) maintained untreated, as the normal control group. Al the rats were observed with scanning electron microscope at 2, 4, 6 weeks after injection, to explore the surface morphology of medial condyle of femur. RESULTS AND CONCLUSION:The condyles of normal and control groups revealed numerous shal ow pits on the surface of articular cartilage. At 2 weeks after injection, the surfaces of condyles were unsmooth, presenting the shrinkage and distortion. The thinner articular cartilage and local tiny cracks were seen at 4 weeks. The deep and great cracks and cartilage defect were observed on the surface of cartilage at 6 weeks. The time of 4-6 weeks is a reference point for establishing early osteoarthritis model in rats through injections of 2%papain and 0.03 mol/L L-cysteine.
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Objective To compare the effect of repairing large perimembranous ventricular septal defect (VSD) with a new continuous stitching and two classical methods. Methods From January 2005 to January 2008,321 cases with VSD were operated. All the cases were divided into 3 groups according to operational way, with discontinuous stitching in group A (70 cases), continuous stitching in group B(116 cases),new continuous stitching in group C (135 cases). All the patients were total corrected with hypothermic cardiopulmonary bypass. Results Group C had the shortest cardiopulmonary bypass and aortic cross-clamp times [(48 ± 36) min and (26 ± 18) min]among the three groups (P < 0.05). Group C had not residual shunt and incidence rate was lowest among the three groups (P < 0.05). Temporary second degree auriculo-ventricular bolck (AVB) was found in the early stage and no third degree AVB among the three groups. Tricuspid regurgitation was higher in group A,but there was no significant difference between group B and group C. Follow-up was completed in a duration of 1-3 years and all the cases had a good health after discharged. Conclusions The new continuous stitching method has short eardiopulmonary bypass and aortic cross-clamp times. It has fewer residual shunt than other two classical methods and has no evidence of higher AVB occurrence.
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Objective To develop a database management system specially applied for medical equipment maintenance administration, Methods Under PowerBuiider/SQL Server development environment, the C/S mode system structure was confirmed and the system function modules were designed. Results The application of C/S mode structure was coincident with the division-cooperation work flow in large and medium hospitals, and the design of function modules met the demand of information collection and utilization of medical equipment maintenance.Conclusion The database management system can preserve the information of medical equipment maintenance effectively and facilitate its usage. Moreover, many statistical indexes about the maintenance administration are available in this system.
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Relative problems in the digital management of medical equipment are explored.Study contents include digital hospital and digital medical equipment,main digital management fields of medical equipment,new progress in technique of digital management.It is pointed out that the digital management of medical equipment is an important part of hospital digital construction,which needs discussion and improvement in practice.
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Ultrasonic estimation of fetal weight is important in the management o f labor and delivery. Lots of charts and formulas have been put forward in virtu e of regression methods. Artificial neural network, a kind of computer artificia l intelligence technology, can simulate human thinking based on neural structure and physiology. With the excellence in complex and non-linear information proce ssing, artificial neural network is fitter for the forecasting of fetal weight t han traditional regression methods.
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Objective To develop medical equipment management information system for medical engineering department. Methods Under PowerBuilder9.0/SQL and Server2000 development environment, the C/S mode system structure was adopted, and the system function modules, such as data input, browsing, querying, statistical analyzing, report generating, were designed. Results Data exchange between client and server was realized. Meanwhile, the designed function modules achieved normal operation. Conclusion The system structure and functions meet the requirements of working practice in medical engineering department.
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After introducing the predominance and status of remote maintenance,the paper lays emphasis on analyzing its application in medical equipment and problems to be solved in the development.Besides,the developing trend of remote maintenance is forecasted.Remote maintenance is one of the development directions for medical equipment maintenance support.
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The ideal valve substitute should have cellular viability. Cryopreserved allograft has cellular viability in some degree, but the quantity, viability and function of the cells are affected by some preexistent factors such as chemical injury, hypoxia during valve processing and injury at the time of implantation. Early cellular autolysis and apoptosis take place not long after implantation, the implanted valve thus loses significant capacity to grow, remodel, or exhibit active metabolic functions. The viable donor cells are antigenic and capable of eliciting immune response, including antigenic and antigen-specific T cells. Calcification appears to originate in residual nonviable cells and their fragments. Proteinases released from endothelial and fibroblast cells of allograft heart valve will lead to the destruction of the valve matrix. One of the focuses of creating an ideal heart valve is the progressive recellularization of the valve matrix by the autologous cells. The acellular valve matrix, after being recellularized, has two characters: cellular viability and normal cellular function, which are the bases of creating ideal bioprosthetic valve with the potentiality of growing, repairing and remodeling.
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Animals , Bioprosthesis , Cryopreservation , Methods , Graft Survival , Heart Valve Prosthesis , Heart Valves , Cell Biology , Prosthesis DesignABSTRACT
Objective To perform multi -condition combination query in the browse window based on PowerBuilder datawindow technology. Methods After the interested combination of query conditions specified on certain columns in datawindow was constructed by if...then statement, the setfilter () and filter () function was used to retrieve and display data which met the filter criteria. Results A flexible query object was incorporated into the data browsing window. Conclusion The datawindow-based query is suitable for situations where batch of data are filtered against not so many columns.
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Objective To access images of medical equipments in database management system. Methods Images in SQL Server2000 can be stored inside database tables directly as the binary content of a Blob field. Under the PowerBuilder development environment, SelectBlob and UpdateBlob are used to perform the data exchange between the Blob field and a Blob variable defined in Powerscript,then image contained in the Blob variable can be constructed in a picture control available in PowerBuilder. Results It is convenient and expeditious to insert, update and present images in this PowerBuilder application. Conclusion Processing images in the medical equipments database management system extends its functions and has a significant applied value.