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Objective:To establish a novel clinical application process of the optical surface monitoring system (OSMS) in the cranial frameless stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT), and to assess the accuracy and effectiveness of the OSMS in the intra-fraction motion monitoring of both cranial phantoms and cranial SRT patients fixed using the Q-Fix encompass immobilization system.Methods:The deviations of OSMS in the real-time motion monitoring were assessed by determining the deviations between the displacement of the cranial SRS phantoms detected by the OSMS and the predefined displacement of the Varian Edge six degrees of freedom (6DoF) couch. The ability of the OSMS to conduct real-time monitoring of the head movement was also analyzed when one camera was blocked by the rotary gantry of the accelerator and when the couch was at non-zero angles. Moreover, ten patients who received 50 fractions of cranial frameless SRT were enrolled in this study. All the patients were fixed using the Q-Fix Encompass system, and their intra-fraction motion was monitored using the OSMS. The intra-fraction errors of OSMS real-time monitoring throughout the treatment were obtained from the OSMS logs. The patients received cone-beam computed tomography (CBCT) after the beam delivery, and the six-dimensional errors were obtained as intra-fraction motion errors of the CBCT.Results:For the cranial phantoms, there was a close correlation between the OSMS monitoring deviations and the predefined displacement in six dimensions. The OSMS-detected 3D vector deviations in the translational and rotational directions were (0.28±0.10) mm and (0.15±0.09)°, respectively when the angel both the gantry and couch was 0° and were (0.35±0.13) mm and(0.17±0.09)°, respectively, when one camera was blocked. The OSMS monitoring deviations with the couch at a non-zero degree were greater than those at zero degree. The maximum deviations occurred when the couch was at 270° and were (0.69±0.19) mm and (0.32±0.12)°, respectively, in the translational and rotational directions. For the cranial SRT patients fixed using the Q-Fix Encompass system, the OSMS and CBCT showed comparable intra-fractional motion deviations, which were (0.40±0.26) and (0.29±0.10) mm, respectively in the translational direction and were (0.33±0.20)°and (0.26±0.08)° in the rotational direction.Conclusions:The OSMS is an effective tool for optically guided radiotherapy, which allows for intra-fraction real-time motion monitoring with sub-millimeter accuracy. Therefore, to ensure the accurate preformation of cranial SRS/SRT, it is necessary to conduct the intra-fractional position monitoring using OSMS.
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ObjectiveTo explore the factors associated with the risk of violent behaviour in inpatients with acute mental disorders， and to provide references for early detection and intervention of violent behaviour in patients with acute mental disorders. MethodsBased on the medical record system of the Affiliated Brain Hospital of Guangzhou Medical University， 1 107 inpatients with acute mental disorders from January to December 2016 were selected， all of whom met the diagnostic criteria of International Classification of Diseases， tenth edition （ICD-10）. At admission， the risk assessment tools were used to assess the risk level of violent behaviour of inpatients， and 8 variables containing general demographic data and clinical data were selected to explore the factors associated with the risk of violent behaviour in inpatients with acute mental disorders. Thereafter， Logistic regression analysis was performed to screen the factors affecting the high risk of violent behaviour among inpatients. ResultsAmong the 1 107 inpatients with acute mental disorders， 357 （32.25%） patients were at high risk of violence. Regression analysis showed that gender of male （OR=1.747， 95% CI： 1.303~2.342）， manic episodes （OR=2.018， 95% CI： 1.310~3.108） and emergency admission （OR=4.244， 95% CI： 3.083~5.840） were risk factors affecting the high risk of violent behaviour of inpatients. Among different types of mental disorders， patients with depressive disorder had a relatively low risk of violent behaviour （OR=0.397， 95% CI： 0.233~0.677）. ConclusionAmong inpatients with acute mental disorders， patients of emergency admission， being male and manic episodes are more likely to be at high risk of violent behaviour.
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Objective To investigate the levels of serum macrophage inflammatory protein-1α (MIP-1α),inflammatory factors and pulnonary function in patients with asthma,and the correlation between thenm.Methods Eighty patients with asthma were selected who were treated in our hospital from March 2015 to August 2016,and the data of 80 healthy adults were selected as control.The differences of serum MIP-1α,inflammatory factors,imnmunoglobulin and lung function were observed in two groups.The correlation between MIP-1α and inflammatory factors,lung function and immunoglobulin were analyzed.Results The levels of MIP-1α,interleukin (IL)-6,and tumor necrosis factor-α (TNF-α) in patients with asthma were significantly higher than those in control group (t =-207.04,-33.209,-55.132,P ＜ 0.01);The levels of forced vital capacity (FVC),the forced expiratory volume in one second (FEV1),FEV1/FVC,maximal mid expiratory flow (MMEF),and peak expiratory flow (PEF) in the asthma group were significantly lower than those in the control group (t =17.100,39.154,22.791,25.391,19.356,P ＜ 0.01).The IgG and IgM of asthma group were significantly lower than those of the control group (t =9.564,7.528,P ＜ 0.01).The IgE level was significantly higher than that of the control group (t =-82.683,P ＜0.01).The level of MIP-1α was positively correlated with the levels of IL-6,TNF-0 and IgE,and negatively correlated with FVC,FEV1,FEV1/FVC,MMEF,PEF,IgG and IgM in patients with asthma.Conclusions The level of serum MIP-1 α in asthmatic patients is high,and is closely related to the inflammatory cytokines and lung function in patients with asthma.
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Objective To investigate the prevalence rate of thyroid nodules as well as related influencing factors. Methods In this clinical study, 8,912 healthy people were included, involving medical staff, teachers, electric enterprise staff and civil authorities from January to December in 2014 . The prevalence rate of thyroid nodules and related influencing factors were investigated . Results (1) The prevalence rate of thyroid nodules was 40.4%, 34.9%for male and 46.7%for female. The prevalence of female was higher than that of male (P<0.001);(2) The prevalence rate of thyroid nodules showed a trend of increase with age (P<0.01);(3) The prevalence rate of thyroid nodules in medical staff and teachers was significantly higher than others (P<0.001);(4) The difference was statistically significant in BMI, blood pressure, blood lipid, blood glucose in thyroid nodule group and non thyroid nodules group (P<0.001). All indexes mentioned above of thyroid nodule group was much higher than those of non thyroid nodules group. (5) The prevalence rate of breast hyperplasia of females under the age of fifty years was significantly higher than those of non thyroid nodule group (P<0.001). Conclusion The prevalence rate of thyroid nodules is high. It is related to gender, age, occupation and estrogen. Effective measures should be taken to change people's bad habits, blood sugar control and blood pressure, reduce BMI and work tension in order to reduce the incidence of thyroid nodules.
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Objective To evaluate the role of thoracoscopy-assisted mini-incision in surgical treatment of lung tuberculosis.Methods From 1999 to 2004,pulmonary lobectomy was performed with thoracoscopy-assisted mini-incision(5-7 cm) on 42 patients with lung tuberculosis(right superior lobectomy in 16,right middle lobectomy in 4,right inferior lobectomy in 4,left superior lobectomy in 10,left lingular lobectomy in 4,and left inferior lobectomy in 4).Results None of the patients were converted to open surgery.The mean operation time was 105 min(35-170 min);blood loss ranged 100-800 ml(mean,150 ml).In the patients,thoracic drainage lasted for 1-5 d(mean,2.8 d) after the operation,and the hospital stay was 4-11 d(mean,6.7 d).During a 2-to 13-month follow-up(mean,8.2),no patient showed positive sputum,bronchopleural fistula,or diffusion of tuberculosis.Conclusions Since thoracoscopy-assisted mini-incision is assosiated with minimal tissue injury,few blood loss,quick postoperative recovery,short hospital stay,and few complications after the surgical treatment of lung tuberculosis,it is worth being widely used.For surgeons,it is important to remember the indications for the procedure.
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Objective To investigate the anesthetic action of intraperitoneal (i.p.) emulsified isoflurane and determine ED50 and LD50 in rats. Methods One hundred and thirty SD rats aged 6-8 weeks veighing 120-150 g were randomly divided into three groups: (A) control group ( n = 10) ; (B) ED50 group ( n = 60) ; (C) LDSO group (n = 60) . Group B and C were further divided into 6 subgroups with 10 animals (5 male, 5 female) in each subgroup. In control group a single bolus of 30% emulsified fat 2ml/100g body weight was administered i. p. In ED50 group a single bolus of 2.30% -6.0% vol/vol emulaified isoflurane 1.5 ml/100 g was administered i. p. and righting reflex was recorded. In LD50 group a single bolus of 4.09% - 10.64% vol/vol emulsified isoflurane 2 ml?100 g-1 was given i.p. and toxic response and lethal dose were recorded. The concentration ratio of the two neighbouring subgroups was 1:0.825. Results The ED50 of emulsified isoflurane was (0.57?0.07) ml.kg-1 and 95% confidence limit (CL) was (0.51-0.64)ml?kg-1 . The average onset time of action was (2.64 ?0.99) min and the average duration of action was (28 ? 11) min. The LD50 of emulsified isoflurane was (1. 26 ?0.10) ml?kg-1 and 95% confidence limit was 1.10-1.45 ml?kg-1 . The therapeutic index (LD50/ED50)was 2. 24. Conclusion Intraperitoneal emulsified isoflurane can provide effective general anesthesia and can be used for animal experiments which need anesthesia of short duration.