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1.
Article in Chinese | WPRIM | ID: wpr-910533

ABSTRACT

Objective:To help clinicians simplify the post-processing operations of structures by developing rapid processing software for target area and organs at risk structures based on ESAPI.Methods:SmartStructure script software was developed based on ESAPI, verified and evaluated in clinical work. 10 cases of rectal cancer receiving neoadjuvant radiotherapy, 10 breast cancer treated with postoperative radiotherapy, 10 cervical cancer receiving postoperative radiotherapy, 10 nasopharyngeal carcinoma receiving radical radiotherapy and 10 lung stereotactic body radiotherapy (SBRT) were selected, and different types of tumors had different post-processing operations of structures. In each case, three methods were used for post-processing of structures. In the control group (manual group), normal manual processing was employed. In the experimental group 1(SmaStru-N group), scripts without templates were utilized. In the experimental group 2(SmaStru-P group). scripts combined with templates were adopted. The processing time of the three methods was compared. Clinicians scored the scripting software from multiple aspects and compared the feeling scores of scripting software and manual operation.Results:All three methods can be normally applied in clinical settings. The error rate in the manual group was 7.0%, 3.0% in the SmaStru-N group 0% in the SmaStru-P group, respectively. Compared with the manual method, SmaStru-N shortened the processing time of target area and organs at risk by 60.9% and 93.3% for SmaStru-P. In addition, SmartStructure was superior to manual method in terms of using feeling scores. Clinicians gave lower score for the" applicability" and" simplicity" , and higher score on the" accuracy" and" efficiency" .Conclusions:Compared with conventional manual structure processing method, SmartStructure software can rapidly and accurately process all structures of the target area and organs at risk, and its advantages become more obvious with the increasing number of structures that need to be processed. SmartStructure software can meet clinical requirements, reduce the error rate, elevate processing speed, improve the working efficiency of clinicians, providing basis for the development of adaptive radiotherapy.

2.
Article in Chinese | WPRIM | ID: wpr-910519

ABSTRACT

Radiation therapy plays an important role in the adjuvant treatment of patients with early endometrial carcinoma. Vaginal stump is a common site of disease failure for early endometrial carcinoma patients with intermediate-high risk factors for recurrence. Compared with external beam radiotherapy, vaginal brachytherapy (VBT) can achieve comparable local control rate with fewer toxicities. In this article, research progresses upon the application of VBT in patients with early endometrial carcinoma after hysterectomy were investigated from multiple perspectives of the selection of patients, the selection of vaginal applicator, factors influencing dose distribution, image-guided adaptive brachytherapy, the design and implementation of radiotherapy regime. In addition, the application of intensity-modulated VBT and the usage of novel quality assurance equipment were also discussed.

3.
Article in Chinese | WPRIM | ID: wpr-910485

ABSTRACT

Objective:To compare the dosimetric parameters and plan complexity between newly-delicated HyperArc (HA) and conventional volumetric-modulated arc therapy (VMAT) in the treatment of brain metastases.Methods:For 26 patients with brain metastases, HA, conventional coplanar (Cop) and non-coplanar (Non-cop) VMAT plans with a prescription dose of 9 Gy 3fx or 6 Gy 5fx were generated. The dosimetric parameters for planning target volume (PTV), RTOG conformity index (RTOG CI), Paddick CI, homogeneity index (HI), gradient index (GI), maximum dose (D max) of brainstem and dose-volume parameters of brain-PTV(V 2Gy-V 26Gy) were statisticaly compared among these three approaches. In addition, the monitor unit (MU) and the plan complexity parameters (including MCSv and AlPO) were statistically compared. Results:To prevent missed targets during treatment, all plans were established with RTOG CI of greater than 1.1. For Paddick CI, HA provided significantly higher conformity (0.89±0.019) than Non-cop (0.87±0.036, P=0.001) and Cop (0.88±0.017, P=0.003) VMAT. For GI, the fastest dose fall-off was noted in HA (3.35±0.64), followed by conventional Non-cop VMAT of (3.70±0.80), and conventional Cop VMAT of (4.90±1.85)(all P<0.05). For the brainstem sparing, HA plan performed better than Non-cop plan[(604.14±531.61) cGy vs.(682.75±558.22) cGy, P<0.05)]. For normal brain tissue sparing, HA approach showed significant reduction than conventional Cop and Non-cop VMAT (both P<0.05). For MU, HA approach (2 872.60 ± 566.93) was significantly lower than those of Non-cop VMAT (3 771.28 ± 1 022.38, P<0.05) and Cop VMAT (4 494.08 ± 1 323.09, P<0.05). In terms of plan complexity, the MCSv of Cop plan was the lowest, indicating that the complexity was the highest ( P<0.05). The AlPO of HA was significantly higher than that of Non-cop VMAT ( P<0.05), suggesting that the complexity of HA plan was lower ( P<0.05). Conclusion:For the treatment of brain metastases, HA provides better conformity, more rapid dose fall-off, better sparing of brainstem and normal brain tissues and less plan complexity compared with conventional VMAT.

4.
Article in Chinese | WPRIM | ID: wpr-910406

ABSTRACT

Objective:To study the feasibility of using pelvic iterative cone beam CT images for dose calculation of radiation therapy planning, so as to provide support for adaptive radiotherapy.Methods:The CIRS 062 M phantom was scanned by Varian Halcyon v2.0 o-ring accelerator, and the average CT number under different scattering conditions was calculated, and then the ICBCT-ED conversion curve was established. CT images of CIRS 002PRA pelvic IMRT phantom and ICBCT images at different positions were collected. Treatment plan using VMAT technique based on CT image was designed and transplanted into ICBCT image with dose recalculated. The differences of gamma passing rate among target volume, organs at risk and 3-dimensional dose were compared. Based on the actual treatment plan of patients, the differences of 3-dimensional dose gamma passing rate in 10 pelvic patients were analyzed retrospectively.Results:There was a large CT value deviation at central position between the isolated no-scattering condition and the full-scattering condition, and the maximum deviation was 144 HU. The CT values of other positions in full-scattering condition were similar to those of the central position, and the maximum deviation was less than 50 HU. Based on the calculated result of ICBCT images at different positions of the pelvic phantom, the dose deviation of the target volume or organs at risk was less than 1 Gy. Compared with the plan based on CT images, the average 3-dimensional dose gamma passing rate under the criteria of 1% dose difference (DD)/1 mm distance-to-agreement (DTA) and 2% DD/2 mm DTA in plan based on ICBCT images were (88.86 ±1.18)% and (98.38±0.89)%, respectively. The ranges of average 3-dimensional dose gamma passing rate under the criteria of 2% DD/2 mm DTA and 3% DD/3 mm DTA in 10 patients with pelvic tumors were 90.03%-95.43% and 93.58%-97.78%, respectively, and the worst result was only 85.90% and 92.90%, respectively. The main reason of the worst result was the dose difference caused by large variation of bladder contour due to over-filling.Conclusions:Under comprehensive scattering conditions, the ICBCT-ED conversion curve is reconstructed and the treatment plan can be designed by using the ICBCT image of Halcyon v2.0 linear accelerator. The accuracy meets the standards of clinical application, which provides assurance for adaptive radiotherapy in the future.

5.
Article in Chinese | WPRIM | ID: wpr-910352

ABSTRACT

Objective:To compare the calculation result and analyzes the reasons for their differences so as to provide reference for the revision and improvement of the current national standards on radiation shielding design for the room of brachytherapy.Methods:For the initial activity 10 Ci (1 Ci=3.7×10 10 Bq) of radioactive sources, the shielding schemes of brachytherapy room were designed in accordance with UK Institnte of Physics and Engineering in Medicine(IPEM) Report 75, USA NCRP Report 151 and the national standard GBZ/T 201.3-2014, respectively. The differences in shielding limits, occupancy factors and other relevant factors are compared in detail. Results:The annual exposure time in a typical brachytherpy room was about 330 h. The point-specific concrete thickness were 70, 65, 61, 70, 50 cm as required by NCRP Report 151, 41, 43, 30, 40, 39 cm by IREM regulations and 84, 79, 46, 88, 39 cm by GBZ/T 201.3, respectively. The concerned concrete shielding thickness calculated under the GBZ/T 201.3-2014 was generally thicker, with lesser difference from NCRP Report 151 result, whereas that from the IPEM75 report was thinnest. The equivalent lead shielding thicknesses of the protective doors calculated using the three method are 1.170, 0.854 and 1.040 cm, respectively.Conclusions:The shielding thickness calculated using the calculation method and evaluation index recommended by the current Chinese shielding standards for brachytherapy bunker is similar to that reported in NCRP151, but is conservative. In particular, the evaluation index of instantaneous dose equivalent rate required by the current national standards and the relative conservative value of occupancy factor will significantly increase the shielding thickness required by the main shielding area.

6.
Article in Chinese | WPRIM | ID: wpr-907895

ABSTRACT

The clinical data of a newborn with Kleefstra syndrome combined with SLC2A1 gene mutation in the Department of Newborn Infants, Children′s Hospital of Nanjing Medical University were retrospectively analyzed.The laboratory examination, genetic characteristics, diagnosis and treatment progress were analyzed.This is the first report of a newborn with Kleefstra syndrome combined with SLC2A1 gene mutation, presenting with an early-onset epilepsy.Gene analysis is the most reliable method to make a definitive diagnosis.

7.
Article in Chinese | WPRIM | ID: wpr-907309

ABSTRACT

Objective:To investigate the role of follicular helper T(Tfh) cells and galactose deficiency IgA 1(Gd-IgA 1) in the children that were suffering from Henoch-Sch?nlein purpura(HSP) and Henoch-Sch?nlein purpura nephritis(HSPN)and the correlation between them. Methods:According to the presence or absence of renal injury, 62 children with HSP were divided into HSP group with 32 children and HSPN group with 30 children.Twenty children who underwent physical examination at outpatients were known as the healthy control group.Flow cytometry was used to measure the proportion of Tfh(CD4 + CXCR5 + PD-1 + ) in peripheral blood.Immunoturbidimetry and ELISA were used to measure the serum levels of IgA 1 and Gd-IgA 1 respectively. Results:(1) The proportion of Tfh cells in peripheral blood and the serum levels of Gd-IgA 1 in both HSP group and HSPN group had significantly increased than those in healthy control group( P<0.01). Compared result of the HSPN group with HSP group, the proportion of Tfh cells in peripheral blood and the serum levels of Gd-IgA 1 in HSPN group were higher than that in HSP group( P<0.05). (2) In the HSPN group, the proportion of peripheral blood Tfh cells and the serum levels of Gd-IgA 1 in group of renal pathology ≥ grade Ⅲ and heavy proteinuria were significantly elevated compared with group of renal pathology < grade Ⅲ and non-heavy proteinuria(<0.01). (3) In the healthy control group, the serum levels of Gd-IgA 1 was positively correlated with the proportion of Tfh cells in peripheral blood and the serum levels of Gd-IgA 1( P<0.05). Conversely, a non-positive correlation was shown in HSP and HSPN groups( P>0.05). Conclusion:The excessive activation of Tfh cells and the serum levels of Gd-IgA 1 may be one of the pathogenesis of HSP/HSPN, the degree of increment of the two factors may be related to the activity and severity of the disease.The mechanism of Tfh cells potentially leading to an increase of Gd-IgA 1 production requires further study.

8.
Article in Chinese | WPRIM | ID: wpr-879846

ABSTRACT

OBJECTIVE@#To study the clinical features of vesicoureteral reflux (VUR) in children with neurogenic bladder (NB), and to provide a reference for its early diagnosis and treatment.@*METHODS@#Clinical data were collected from 26 children with NB and urinary tract infection who were admitted to the Department of Pediatric Nephrology from January 2014 to December 2019. According to the presence or absence of VUR, the children were divided into a VUR group with 11 children and a non-VUR group with 15 children. Clinical features were compared between the two groups.@*RESULTS@#Compared with the non-VUR group, the VUR group had a significantly higher proportion of children with non-@*CONCLUSIONS@#When NB children have the clinical manifestations of non-


Subject(s)
Child , Creatinine , Humans , Infant , Radionuclide Imaging , Urinary Bladder, Neurogenic/etiology , Urinary Tract Infections/etiology , Vesico-Ureteral Reflux/diagnostic imaging
9.
Article in Chinese | WPRIM | ID: wpr-868731

ABSTRACT

Objective:To discuss the design details of accelerator room for a novel enclosed O-ring linac Halcyon, and to optimize its protection and layout.Methods:According to the optimization principle of radiation protection and the requirements of national radiation protection standards, and the structural characteristics of Halcyon accelerator, the differences between conventional and this novel accelerator rooms were analyzed by discussing the space layout of the machine room, shielding calculation, electrical facilities, purifying ventilation, temperature and humidity control and other factors.Results:The Halcyon machine had a compact structure, a closed ring frame design and a main beam shielding device, which could greatly reduce the radiation protection pressure while improving the space utilization rate of the machine room. The optimized design layout of the machine room could eliminate hidden dangers, avoid design defects, and prevent adverse consequences caused by design errors.Conclusions:The overall structure of Halcyon accelerator is different from that of conventional accelerators. The design details should be taken into full consideration to ensure the optimization of radiation protection, lay a good foundation for subsequent installation, debugging and operation of the equipment and create a good treatment environment for patients and medical staff.

10.
Journal of Experimental Hematology ; (6): 1952-1956, 2020.
Article in Chinese | WPRIM | ID: wpr-879998

ABSTRACT

OBJECTIVE@#To detect the relationship between CTGF in the bone marrow of MM patients and osteolytic lesion of myeloma, moreover, to investigate the clinical significance of CTGF in MM.@*METHODS@#Fifity-four MM patients treated in our hospital from March 2019 to April 2020 were enrolled, and 28 healthy volunteers were selected as the control group. The plasma in bone marrow of the patients was collected, and the ELISA was used to detect the level of CTGF in bone marrow plasma and the relationship between its and clinical characteristics were statistically analyzed.@*RESULTS@#The CTGF level of MM patients was significantly higher than those in the healthy control group (P<0.001); the CTGF level in male patients was higher than that in female patients (P=0.007); the CTGF level in MM patients with osteolytic lesions was significantly higher than patients without osteolytic lesions and controls (P=0.007, P=0.001). The CTGF level in MM patients was positively correlated with the number of bone lesions (P<0.001, r=0.52). CTGF levels in patients with ≥3 bone lesions were significantly higher than those with <3 bone lesions and without bone lesions (P=0.014, P=0.002). ROC curve result showed that CTGF expression level shows a significant diagnostic value for MM bone disease (P<0.001).@*CONCLUSION@#The abnormally high expression of CTGF level in MM patients is related to the degree of myelomas osteolytic lesions and can reflect the progress of MM.


Subject(s)
Bone Marrow , Connective Tissue Growth Factor , Female , Humans , Male , Multiple Myeloma , Osteolysis , Patients , ROC Curve
11.
Article in Chinese | WPRIM | ID: wpr-734364

ABSTRACT

Objective To analyze the failure and processing methods of helical tomotherapy multileaf collimator (MLC) and summarize relevant maintenance experience,aiming to accurately identify the faulty parts,shorten the downtime and enhance the work time.Methods The failure data of the helical tomotherapy MLC system in the past 48 months were analyzed to identify the common faulty parts,causes and processing methods.Results During the previous 48 months,the MLC failure occurred for 20 times,11 times for air compressor failure,4 times for position verification board failure,twice for leaf driver failure,twice for cushion valve failure and once for the slip of leaf position verification rod.The MLC failure was significantly correlated with the humidity of high-pressure gas.The work time of machine exerted significant effect upon the service time of MLC parts.Conclusions The structure of the helical tomotherapy MLC system is complex.The high-intensity work increases the failure rate.The humidity of high-pressure gas affects the normal operation of the MLC equipment.The faulty parts can be identified,the downtime can be reduced and the work time can be enhanced by summarizing the experience of MLC maintenance.

12.
Article in Chinese | WPRIM | ID: wpr-775054

ABSTRACT

OBJECTIVE@#To study the long-term prognosis of vesicoureteral reflux in children.@*METHODS@#A retrospective analysis was performed for the clinical data of 138 children (218 ureters with reflux) who were diagnosed with vesicoureteral reflux for the first time from November 2005 to March 2017 and received medical treatment and regular follow-up. According to the initial grade of reflux, the ureters with reflux were divided into a low-grade group (141 ureters, grade I-III) and a high-grade group (77 ureters, grade IV-V), and the two groups were compared in terms of clinical data and follow-up results.@*RESULTS@#Among the 138 children, there were 82 boys and 56 girls. Their age ranged from 31 days to 10 years at the time of confirmed diagnosis, with a median age of 8 months. The follow-up time ranged from 8 months to 7 years, with a median follow-up time of 1.4 years. At the time of confirmed diagnosis, the high-grade group had significantly higher levels of urinary N-acetyl-β-D-glucosaminidase, urinary microalbumin and urinary immunoglobulin G than the low-grade group (P<0.05). Among the 218 ureters with reflux, 132 (60.6%) achieved a reduction in the grade of reflux (among which 74 achieved complete disappearance of reflux), 43 had no change in the grade of reflux, and 43 had an increase in the grade of reflux. Compared with the high-grade group, the low-grade group had a significantly higher complete remission rate (41.1% vs 19.5%, P=0.001) and a significantly shorter time to complete remission of reflux (P=0.002).@*CONCLUSIONS@#Most children with vesicoureteral reflux can achieve a reduction in the grade of reflux or even complete disappearance of reflux during follow-up, and the children with low-grade reflux have better prognosis than those with high-grade reflux.


Subject(s)
Child , Child, Preschool , Female , Follow-Up Studies , Humans , Infant , Male , Prognosis , Retrospective Studies , Vesico-Ureteral Reflux
13.
Article in Chinese | WPRIM | ID: wpr-696181

ABSTRACT

Objective A fluorescence PCR methods was developed to detect EV71 and CoxAl6 and other enteroviruses simultaneously,which used for hand,foot and mouth disease (HFMD) viruses in the clinical rapid diagnosis.Methods Designed specific primers and probes of the enteroviruses gene which represents one of the highly conserved regions of the virus gene,and optimized the detection system of real-time quantitative RT-PCR.The positive control template and the standard curve were constructed.Researched the limit of detection,repeatability and specificity of the products,and tested 26 positive samples and 10 negative samples which collected on June 2015.Results The results showed that this experiment obtained positive recombinant plasmid,the range of the linear relation was from 8 × 102 to 8 × 108 copies/μl,and the detection result within this range was fine.The optimal concentrations of EVUN upstream and downstream primers were 0.50 μmol/L and the MGB probes were 0.30 μmol/L,RT-PCR reaction conditions as follows:42℃ 30 min,95℃ 3 min.95℃ 5 s,60℃ 35 s,45 cycle.The limit of detection reached to 800 copies/μl.The CV of the repeatability assay was no more than 5%.Specificity was good,and no cross reaction with other infectious viruses.26 clinical positive samples and 10 negative samples were detected in this experiment,detection rate of positive samples was 100 % (26/26) and negative samples was 100 % (10/10) by fluorescent quantitative RT-PCR detection method.Conclusion The experiment demonstrated that the detection method of the fluorescent quantitative PCR for hand-foot-mouth viruses could be used for the rapid diagnosis in clinical application.

14.
Article in Chinese | WPRIM | ID: wpr-708271

ABSTRACT

Objective To evaluate the anxiety and explore relevant risk factors in patients receiving radiotherapy and their relatives,aiming to provide evidence for improving the quality of life. Methods Before radiotherapy,the self-rating anxiety scale (SAS) was utilized to evaluate the anxiety of patients and their relatives. The incidence rate of anxiety was analyzed under the influence from different risk factors. Results A total of 646 participants (463 patients and 183 relatives) were included in this study. The average SAS scores of all participants,patients and family relatives were 41.52±10. 08,41.02±19. 37 and 42.79±11. 56, significantly higher than 37.23±12. 58 for the healthy population in China (P= 0. 000. 0.000,0. 000).For patients aged 11-30,31-50 and 51-90 years,the incidence rate of anxiety was 26%(7/ 26),11. 0%(20/ 182) and 19. 1%(47/ 246),respectively (P= 0. 026).The incidence rate of anxiety for patients with and without tumor recurrence was 27% (13/ 48) and 15. 4% (64/ 415) (P= 0. 040).Seventeen of 63 patients (27%) with metastases experienced anxiety,whereas 60 of 396 patients (15. 2%) without metastases suffered from anxiety (P= 0. 020).The incidence rate of anxiety in patients with three or more chronic diseases was 26%(19/ 74),significantly higher compared with 15. 0%(58/ 387) in those with less comorbidities (P= 0. 024). Multivariate binary logistic regression analysis demonstrated that three or more chronic diseases or serious diseases were high risk factors of anxiety (OR= 1. 92,95%CI:1. 03-3. 567). Conclusions Patients who receive radiotherapy and their relatives are prone to anxiety. Young age,tumor recurrence or metastasis and≥ three comorbidities or severe diseases are the high risk factors of anxiety. It is necessary to evaluate the anxiety of patients and their family relatives before radiotherapy and deliver psychological counseling.

15.
Article in Chinese | WPRIM | ID: wpr-708261

ABSTRACT

Objective To measure the irradiation doses from the image beam line (IBL) of Artiste linac under the 2Dplanar,MV CBCT,6 MV 2Dplanar and Somatom CT modes to select an appropriate image-guided mode combined with the irradiation sites. Methods The head, chest and pelvic phantom doses from the IBL under the 2Dplanar,MV CBCT and 6 MV 2Dplanar modes were measured by using IBA Dose 1 electrometer and FC65 ionization chamber.The irradiation doses of Somatom CT scans of the head, chest and pelvis were measured using IBA Dosimax plus A system and the measurement results were analyzed. Results In the head and neck, the average irradiation dose was 16. 60 mGy under IBL 2Dplanar mode, 58. 73 mGy under IBL MV CBCT mode, 19. 83 mGy under 6 MV 2Dplanar mode and 7-9 mGy under Somatom CT. In the chest, the average irradiation dose was 14. 08 mGy under IBL 2Dplanar mode, 49. 17 mGy under MV CBCT mode, 18. 97 mGy under 6 MV 2Dplanar mode and 9-11 mGy under Somatom CT mode.In the pelvis, the average irradiation dose was 13. 36 mGy under IBL 2Dplanar mode, 45. 65 mGy under MV CBCT mode, 17. 52 mGy under 6 MV 2Dplanar mode and 12-15 mGy under Somatom CT mode. Conclusions In the head and neck, the image quality under IBL 2Dplanar mode is recommended, which is qualified for image registration standards. Somatom CT mode is suitable for the chest. In the pelvic region, IBL 2DPlanar mode can be applied when the intestinal cavity and bladder are well filled, and MV CBCT mode can be chosen if they are poorly filled.

16.
Article in Chinese | WPRIM | ID: wpr-708243

ABSTRACT

Objective To explore and establish accurate detection quality control method of source positioning and timer precision for afterloading equipment. Methods The source positioning detection device was made of hd camera,EBT3 disposable film and steel rule,collecting source in each resident point for video images and film. Accurate measurement of radioactive source positioning and timer accuracy, including the timing absolute error and linear error through analysis of image sampling rate. After the film grayscale distribution analysis,comparison between film gray peak position and the measurement of resident point geometry,got the stay point source physics and radiation center deviation. Results Radioactive source physics and radiation center deviation was (-0.33± 0. 10) mm;For all default dwell time,timer average absolute deviation was (0.22±0. 02) s,linear fitting result was y=x-0. 226,R2=1,timing linear error was-0. 01% Conclusions established detection means through the video images and film exposure quantitative analysis for accurately determination of source positioning,dwell time and source radiation center precision. After experimental testing the machine precision satisfied the requirement of clinical use.

17.
Article in Chinese | WPRIM | ID: wpr-776681

ABSTRACT

OBJECTIVE@#To study the clinical effect of early or late administration of caffeine citrate in the prevention and treatment of apnea in very low birth weight (VLBW) infants.@*METHODS@#A total of 82 VLBW infants who were hospitalized and treated in the neonatal intensive care unit between June 2015 and May 2017 were enrolled. According to the age in days when caffeine citrate treatment was started, they were divided into early treatment group (0.05).@*CONCLUSIONS@#Early administration of caffeine citrate can improve the prognosis of VLBW infants.


Subject(s)
Apnea , Bronchopulmonary Dysplasia , Caffeine , Child , Citrates , Humans , Infant , Infant, Very Low Birth Weight , Retrospective Studies
18.
Chinese Journal of Neonatology ; (6): 364-367, 2018.
Article in Chinese | WPRIM | ID: wpr-699315

ABSTRACT

Objective To study the prevalence and the main risk factors of neonatal asphyxia in southern Gansu province high-altitude area.Method From October 2016 to December 2016,clinical data of neonates born in eight hospitals of the region were analyzed.A uniform questionnaire was used to survey the maternal condition and family background.Univariate and multivariate Logistic regression analysis were used to determine the risk factors of neonatal asphyxia.Result A total of 183 newborns were born with asphyxia (mild 157 cases,severe 26 cases),and the incidence of neonatal asphyxia was 15.3% (183/1 197).The multivariate Logistic regression analysis indicated that the risk factors included altitude less than 3 000 meters (OR =2.693,95% CI 1.275 ~5.689),maternal fever (OR =2.986,95% CI 1.163 ~7.666),prolonged labor (OR =2.925,95% CI 1.112 ~ 7.691),fetal distress (OR =7.000,95% CI 3.254 ~ 15.056),uterine inertia (OR =2.737,95% CI 1.484 ~ 5.047),umbilical cord abnormality (OR =3.094,95% CI 2.051 ~4.668),amniotic fluid abnormality (OR =2.033,95% CI 1.230 ~3.361)and placental abnormality (OR =2.753,95% CI 1.016 ~ 7.464).Annual household income more than 30 000 yuan (OR =0.452,95% CI 0.297 ~0.687) was protective factor of neonatal asphyxia.Conclusion The incidence of neonatal asphyxia was high in the region,which was related to intrauterine and intrapartum factors.Antepartum monitoring and timely treatment should be strengthened to reduce the incidence of newborn asphyxia.

19.
Article in Chinese | WPRIM | ID: wpr-275506

ABSTRACT

The purpose of this paper was to study the pre-mixed materials of emulsion gel. Accessories were screened and formula was designed with the most common use, low cost and simple process as the standards. Experiments were designed by central composite design-response surface methodology (ccd-rsm). 8.0.6 Trial Design-Expert was used for data processing and analysis, and subjective scores were used as the index to draw the three-dimensional effect surface and 2D contour maps. It was determined that the optimal ranges were A (carbomer 940): 0.05-0.065 g; B (castor oil): 1.00-1.12 mL; C (poly polysorbate-80): 0.15 mL. The optimal formula was as follows: carbopol 0.057 5 g, castor oil 1.1 mL, polysorbate-80 0.15 mL. The formulated substrate was studied on its preliminary stability and rheology characteristics, such as viscosity and thixotropy. Then with the optimal formula as substrate, emulsion type gel was prepared respectively with 98% rutin, 98% berberine hydrochloride, and 98% berbamine hydrochloride as the main component. With 0.9% normal saline as the absorption solution, the results showed that the ransdermal flux of the three formulations of 1 h was all less than 1%. The results indicated that this substrate had the potential to be developed into a premixed material. The emulsion type gel matrix made from this formula had a good appearance, stability to certain extent, appropriate viscosity and thixotropy, and showed no skin irritation in 1 h.

20.
Article in Chinese | WPRIM | ID: wpr-609989

ABSTRACT

Objective To investigate whether the accelerator image beam line (IBL) full scan and extend field of view(EFOV) scan mode megavoltage cone beam CT(MV CBCT) images can be used for dose calculation in adaptive radiotherapy.Methods The large aperture CT and MV CBCT were used to scan the CIRS 062M electron density modules,the CT value was established to electron density curves in the Pinnacle treatment planning system.Also,CT and MV CBCT were used to scan the head and neck,chest,abdomen and pelvis phantom.The intensity modulated radiotherapy(IMRT) plans were made with CT images and transplanted to MV CBCT images.The dose of targets and organs with their electron density curves was calculated,and two type IMRT plans with different CT images were compared.Results The dose distribution of head and neck phantom was acceptable,compared with the reference plan,the difference was within 3 %.The dose distribution of chest and.pelvis was significantly reduced from reference plans,and the difference was 5% and 10% separately.This difference was beyond the scope of clinical acceptance.Conclusions MV CBCT images of accelerator IBL full scan mode in patients with head and neck site scan could be used for dose calculation in adaptive radiotherapy,chest and pelvic sites in EFOV mode scanning MV CBCT images could only be used for image guidance.

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