Modeling the correlations between radiation dose and scanning parameters of XVI cone beam CT / 中华放射医学与防护杂志

Objective To quantify the correlations between Elekta XVI cone beam CT dose and various scanning protocols,providing mathematical models to assess the protocol-dependency of imaging dose during imnage guided radiotherapy.Methods Based on standard protocols and various combinations of kVp and mA on an XVI mounted on an Elekta Versa HD accelerator,the air KERMA was measured at various positions in a standard PTW CTDI body phantom using calibrated PTW 30009 kV chamber and UNIDOS webline electrometer.Weighted CT dose index (CTDIw) was computed thereafter.SigmaPlot 10.0 was used to fit the measurements against mA and/or kVp yielding empirical functions.Results Under standard protocols,the CTDIw of Varian OBI was only 11.23％ (chest) and 9.15％ (pelvis) of Elekta XVI.Using the default and other 4 investigated kVp values,the central and peripheral KERMA were both proportional to mA,and vet the slope value a varied dramatically from 0.479 to 6.679.Major affecting factors included kVp settings,measurement locations,and dosimetric mnetrics,etc.None linear regressions were used to fit kVp against KERMA at various locations and CTDIw (R2 ＞ 0.997).The differences between all coefficients were statistically significant (P ＜ 0.05).The impact of changing both mA and kVp on the dose to phantom center can be described as mGy =(5.917-0.197 ×kVp+0.002 × kVp2-5.063 × 10-6 × kVp3) × mA.Conclusions Imaging dose of Elekta XVI is strongly dependent on scanning paraneters.The proposed mathematical models can be used as efficient and robust indicators of such dependency.

Time of salvage treatment on sudden sensorineural hearing loss / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the best time of intratympanic dexamethasone injection to treat sudden sensorineural hearing loss (SSNHL) as salvage therapy so that to improve the curative efficacy on sudden deafness at the utmost.@*METHOD@#A total of 192 patients with SSNHL were included in this study, among whom 63 cases received the systemic steroid therapy throughout the study, while the other ones were treated with systemic steroid as initial treatment and were given intratympanic steroid administration as salvage treatment starting at different time point. The salvage treatment started on the 3rd day after the beginning of the initial treatment for 29 cases, on the 7th day for 38 cases, on the 14th day for 43 cases, and 1 month later for 19 cases. All the patients were followed up for 2 months.@*RESULT@#The recovery rates and total effective rates showed no statistically significant difference between the patients received only systemic steroid therapy and the ones received intratympanic steroid administration on the 3rd, 7th day and 1 month later after the initial treatment. The recovery rate and total effective rate exhibited statistically significant difference between the patients received intratympanic steroid administration since the 14th day after the initial treatment and the ones received only systemic steroid therapy, with the numerical value of P 0. 037 and 0. 034, respectively.@*CONCLUSION@#(1) As an initial management plan, the curative effects. between the intratympanic steroid administration and the systemic steroid therapy were not significantly different. (2) As a salvage treatment, intratympanic steroid was a better choice for patients who have not completely recover from ISSNHL after failure of initial management with systemic steroid only. (3) The best time point of salvage treatment with intratympanic steroid was about 2 weeks after initial management with systemic steroid.

The effect of hyperbaric oxygen therapy to different degree of hearing loss and types of threshold curve in sudden deafness patients / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the effect of hyperbaric oxygen therapy to different degrees of hearing loss and different types of threshold curve in sudden deafness patients, and establish a personalized therapy, so as to promote clinical effect to sudden deafness.@*METHOD@#One hundred and twenty cases were divided into two groups respectively (each group 60 cases). Drug treatment had been used in group A for two weeks. The patients in group B received drug treatment combined with hyperbaric oxygen therapy for two weeks. According to the different degrees of hearing loss and the types of audiogram in two groups, the statistical analysis to the difference of hyperbaric oxygen therapeutic effect was done.@*RESULT@#The effective rates was statistically different (chi2 = 8.044, P < 0.01) between group A (60.00%, 36/60) and group B (83.33%, 50/60). There was no statistical difference between two treatment program in mild and the profound deafness patients. The statistical difference could been found between moderate and the severe deafness, the value of chi2 and p were 4.969, 5.560 and 0.040, 0.035, respectively. In group A, the statistical difference could only been found between mild and the profound deafness patients (chi2 = 6.739, P < 0.05). In group B, the statistical difference could been found in mild and the profound deafness, the moderate and the profound deafness, the severe and the profound deafness patients. The value of chi2 were 11.500, 15.058,10.221 and P < 0.01 respectively. The effective rates was no statistical difference in two treatment programs in the upsloping audiogram and the profound deafness. The statistical difference could been found between the downsloping and the flat audiogram, with the value of chi2 and p were 5.144 and 5.969, P < 0.05, respectively. In group A, the statistical difference could been found between the ascending and descending audiogram, the ascending and the flat audiogram,the ascending type and the profound deafness. The value of chi2 were 6.188, 7.247, 8.082 and P < 0.05, respectively. No statistical difference could been found among the other types of audiogram. In group B, no statistical difference could been found among all types of audiogram.@*CONCLUSION@#The effect of hyperbaric oxygen therapy varies with degree of hearing loss and audiogram type. Drug treatment combined with HBOT can promote clinical effect for patients in moderate deafness and severe deafness, the descending and flat type of audiogram.

Expression and clinical significance of inducible nitric oxide synthase and β-catenin in nasopharyngeal carcinoma tissue / 中国癌症杂志

Background and purpose: There have been no reports on the clinical and biological significance of the co-expression of inducible nitric oxide synthase (iNOS) and β-catenin (β-cat) in has.pharyngeal carcinoma(NPC). This study was aimed to investigate the expression of iNOS and β-cat in NPC, to analyze their interrelation, and to explore their roles in the carcinogenesis, development, invasion, and metastasis of NPC. Methods: The expression of iNOS and β-cat was examined in 50 poorly differentiated NPC and 15 normal nasopharyngeal epithelium tissue by immunohistochemical staining (SP method). None of the patients had received radiotherapy and chemotherapy. The results of immunostaining were observed by two pathologists independently, using double blind scoring method. iNOS and β-cat expression were categorized by the extent and intensity of staining using a semiquantitative method. Results: No iNOS expression was observed in 15 normal nasopharyngeal epithelium, but β-cat expression was located in cytomembrane in normal samples. The positive rate of iNOS protein expression was 74.0% (37/50) in NPC tissues. The expression of iNOS was statistically different among the NPC group and normal nasopharyngeal epithelium group, T_(1-2) group and T_(3-4) group, metastatic lymph nodes group and no metastatic lymph nodes group. There was a great quantity of β-cat expression in cytoplasm, little or no β-cat expression in cytomembrane and nucleus in NPC tumorous tissues. Statistical analysis indicated that strong positive expression of β-cat in cytoplasm was significantly higher in NPC than those of normal nasopharyngeal epithelium. The positive expression of β-cat was significantly correlated with clinical stage, invasion and lymph gland metastasis. Neither iNOS nor β-cat was significantly different between different ages and genders. There was a positive relationship between iNOS and β-cat expression in NPC tissues (r=0.394, P=0.005). Conclusion: The positive expressions of iNOS and β-cat in cytoplasm were significantly correlated with clinical stage, invasion and metastasis, and were not significantly different in terms of ages and genders of the patients. There was a positive relationship between the expression of iNOS and β-cat in NPC tissues. Co-overexpression of iNOS and β-cat may play an important role in carcinogenesis, development, invasion, and metastasis of NPC.

Choice of treatment plan and operation time on pediatric chronic sinusitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the curative effect of pediatric chronic sinusitis and analyze its relative factors, so that the best treatment plan and operation time can be choose.@*METHOD@#Two hundred and twenty cases of pediatric chronic sinusitis were divided into 4 groups: group A with only simple chronic sinusitis, group B accompanied adenoid hypertrophy. Among group B, group B1 with no nasal cavity structural abnormalities but group B2 on the contrary. Group C accompanied only nasal cavity structural abnormalities. According to the documents, all patients were administered with standard and systematical three-stage treatment. The curative effect of each group was calculated and analyzed in each treated stage.@*RESULT@#After the first stage treated in 220 pediatric chronic sinusitis, a statistical significance of curative effect could be observed between group A and B, A and B1, A and B2, A and C (P 0.01). Ninety-four patients in group B were accepted the second stage treated: adenoidectomy after first treatment failed. There was a statistical significance of curative effect between group B1 and B2 (P < 0.01). Once the above management both failed, endoscopic sinus surgery (FESS) was carried out. The total effective rate of FESS was 89.65%.@*CONCLUSION@#The systemic, disciplinary medical management has some referred value in the treatment for children with chronic sinusitis. Adenoid hypertrophy and nasal cavity structural abnormalities are two relative factors of the curative effect in pediatric chronic sinusitis. The time and cost of therapy can be saved if adenoidectomy and FESS are done for cases with adenoid hypertrophy or (and) nasal cavity structural abnormalities with the systemic, disciplinary medical management simultaneously.

The value of cyclooxygenase-2 to predict the effect of radiotherapy in nasopharyngeal carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the relation between the expression of COX-2 protein and the effect of radiotherapy, estimate the value of COX-2 in predicting the effect of radiotherapy in patients with nasopharyngeal carcinoma,provide theoretical basement for establishing characteristic project of treatment and raising curative effect and life quantity.@*METHOD@#The expression of COX-2 protein was examined in 30 radiosensitive and 30 radioresistant poorly differentiated NPC by immunohistochemical staining (SP method) before radiotherapy. The relation between the expression of COX-2 and the effect of radiotherapy was analyzed.@*RESULT@#The positive rate of COX-2 protein expression was 61. 67% in NPC tissues, there was statistical difference( P <0. 01) of the positive rate between the 86. 67 % of 30 radioresistant and 36. 67 % of radiosensitive NPC tissues. The intensity of COX-2 protein expressions showed statistical difference( P <0. 05),too. Based on the expression of COX-2, the effect of radiotherapy, sensitivity, specificity, accuracy, positive predictive value, negative predictive value, false positive and false negative were predicted as follows: 86. 67Y, 63. 33% ,75. 00%, 70. 27% ,82. 61% ,36. 67% and 13. 33 , respectively.@*CONCLUSION@#COX-2 expression may serve as a marker in predicting the response to radiotherapy in NPC. According to the expression of COX-2, the sound treatment scheme can be selected.

Effect of constant magnetic field on the osteopontin gene expression in rat aorta smooth muscle cells / 中国组织工程研究

BACKGROUND:Constant magnetic field of proper intensity can inhibit the proliferation of vascular smooth muscle cells,and it can be used to inhibit the restenosis following percutaneous coronary intervention.OBJECTIVE: To observe the effect of constant magnetic field of different intensities on the expression of osteopontin gene in rat aorta smooth muscle cells, so as to investigate whether magnetic field can be used to prevent and treat restenosis following percutaneous coronary intervention.DESIGN: A randomly grouping and controlled observation.SETTING: Department of Cardiology, Xijing Hospital of the Fourth Military Medical University of Chinese PLA.MATERIALS: The experiments were carried out in the laboratory of Department of Cardiology (Military Institute of Cardiovascular Disease), Xijing Hospital of the Fourth Military Medical University of Chinese PLA from February to December in 2006. Male pure SD rats of 200-250 g were used.METHODS : Rat aorta smooth muscle cells were cultured in vitro in DMEM medium containing fetal bovine serum (0.1 in volume serum), and then the cells were randomly divided into control group, constant magnetic field of 1, 5, 10 and 50 Gs groups, those in the control group were not treated with magnetic field, and those in the other groups were treated with magnetic field and cultured for another 48 hours. Reverse transcription-polymerase chain reaction and Western blotting were combined with absorbance (A) scanning analysis to observe the effect of constant magnetic field on the expressions of osteopontin and its mRNA in smooth muscle cells.MAIN OUTCOME MEASURES: Expressions of osteopontin and its mRNA in smooth muscle cells.RESULTS: The expressions of osteopontin and osteopontin genes in the constant magnetic field groups were significantly decreased as compared with that in the control group (P ＜ 0.05), there were also significant differences among the constant magnetic field groups of different intensities (P ＜ 0.05). It was indicated that the stimulation of constant magnetic field was in an intensity-dependent manner, and the expressions of osteopontin and osteopontin mRNA were enhanced as the intensity of magnetic field was increased.CONCLUSION: Constant magnetic field of proper intensity can inhibit the osteopontin expression in vascular smooth muscle cells on the gene level, and magnetic field may play a role in preventing and treating the restenosis following percutaneous coronary intervention.

The value of inducible nitric oxide synthase to select the project of treatment in nasopharyngeal carcinoma / 中国癌症杂志

Background and purpose:Concurrent chemo-radiotherapy(CCRT) was considered the best treatment plan for advanced nasopharyngeal carcinoma(NPC),but there was no uniform conclusion as to which category of patients and which chemotherapy associated radiotherapy would have the best therapeutic effect. As the standard treatment plan for advanced NPC, DDP concurrent chemo-radiotherapy was recommended by some scholars. DDP can raise the expression of inducible nitric oxide synthase(iNOS) protein and synthesize nitric oxide (NO) with anti-tumor effects, so we considered whether the therapeutic effect could be predicted and the corresponding treatment plan could be selectived to detect the iNOS expression in the pretherapy NPC tissues.The purpose of this study was to investigate the relation between the expression of iNOS protein and the nasopharyngeal tumor with complete response or with residue after DDP concurrent chemo-radiotherapy, so that the most appropriate plan of treatment can be adopted and the complete response rate of nasopharyngeal tumor can be raised. Methods:All patients were poorly differentiated NPC.The expression of iNOS protein was examined in 30 patients of nasopharyngeal tumor with complete response and 30 patients with residual tumor after DDP concurrent chemo-radiotherapy by immunohistochemical staining (SP method).None of the patients had received radiotherapy and chemotherapy.Results:Immunohistochemical examination revealed that iNOS expression in the NPC tissues was located in both the nucleus and cytoplasm of the tumorous tissues. The intensity of iNOS expression was stronger in the nucleus than in the cytoplasm of the tumorous tissues.The positive rates of iNOS protein expressions were 71.67%(43/60) in NPC tissues. It was 86.67% and 53.33% in 30 tumors with complete response and with residual tumor, respectively. The difference was statistically significant.The rate of iNOS strong postive expressions in the group of residual tumors was higher than that of the group with complete response. It was statistically different,but weak and moderate postive expressions did not have statistical difference.Conclusions:According to the difference of iNOS expression, it is a valuable method to select the most appropriate plan of treatment and the complete response rate of nasopharyngeal tumor can be raised.

Development and application of multifunctional thermostated instrument / 医疗卫生装备

Objective To introduce a multifunctional thermostated instrument applied in pre-floats,floats,roast,special staining,immunohistochemical staining,situ hybridization and frozen sections in order to enhance speed and quality of slice-making.Methods Three lengths of vats were nested and overlaid each other to make up a thermostat box which could stretch out and contract back.Its control part consisted a timer,precise temperature control and adjustable power controller.Source of heat was provided by durable electric heat plate to keep the constant temperature for different operations.Results The equipment provided constant temperature and possesses all the necessary functions.It can be used for the pathological operation and compensate for the shortcomings of medical equipment.Conclusion With small volume and light weight,the equipment is easy to carry.Besides,it has less power consumption,so it is secure and easy to operate.The equipment can meet conventional pathology techniques both in peacetime and wartime.

A study on expression of tumor necrosis factor alpha in middle ear cholesteatoma and its effect on bone destruction / 临床耳鼻咽喉头颈外科杂志

Objective:To determine the expression and localization of tumor necrosis factor alpha(TNF-α) in human middle ear cholesteatoma and its effects on bone resorption.Method:The distribution of TNF-α in 18 cholesteatoma tissues and 8 normal external ear canal skin, facial skin and tympanic memebrane were studied immunohistochemically with paraffin-embedded sections.Result:TNF-α was localized in the epitheliun and connective tissue of cholesteatomas studied, particularly on basal and spinous cells and macrophages.The epithelium of normal external ear canal skin , facial skin and tympanic membrane was slightly stained.Conclusion:This study revealed significantly increased level of TNF-α in cholesteatoma tissues.TNF-α acts both directly,by causing bone erosion as an autocrine growth factor,and indirectly as an important mediator by stimulating the release of enzymes causing bone destruction.

Expression of inducible nitric oxide synthase in nasopharyngeal carcinoma(NPC) and its significance / 中国癌症杂志

Background and purpose:Inducible nitric oxide synthase(iNOS) overexpression has been detected in various malignancies.Nitric oxide(NO) produced by iNOS play an important role in the carcinogenesis,growth,invasion,metastasis and angiogenesis of tumors.However,the clinical and biological significance of the expression of iNOS in NPC were rarely reported in the literature.This study was to investigate the expression of iNOS in NPC and its role in the carcinogenesis,development,invasion and metastasis of NPC.Methods:The expression of iNOS was examined in 40 poorly differentiated NPC and 10 normal nasopharyngeal epithelium tissues by immunohistochemical staining(SP method).The results of immunoassaying were observed by two pathologists independently,using double blank scoring method.iNOS expression was categorized on the base of extent and intensity of staining using a semi quantitative method.The immunoreactive score was obtained by multiplying the extent score with the intensity of score.An immunoreactive score of 2 or higher was considered positive expression.Results:① iNOS was expressed in both the nucleus and cytoplasm of the tumor tissues.The intensity of iNOS expression was stronger in the nucleus than in the cytoplasm of the tumor tissues.②iNOS expression were significantly higher in NPC than those of normal nasopharyngeal epithelium.The positive protein expression rates of iNOS were 67.5%(27/40).The positive expressions of iNOS were significantly correlated with clinical stage,invasion and metastasis. There were no significant difference in terms of age and gender.Conclusions:① Immunohistochemical examination revealed that iNOS expression in the NPC tissues was located in both the nucleus and cytoplasm of the tumorous tissues.The intensity of iNOS expression was stronger in the nucleus than in the cytoplasm of the tumorous tissues.②iNOS may play an important role in the carcinogenesis,development,invasion,metastasis of NPC,respectively.The radiotherapeutic response of NPC may be enhanced by using the selective inhibitors of iNOS.