Demand, supply and satisfaction of assistive technology in China based on rapid Assistive Technology Assessment data / 中国康复理论与实践

ObjectiveTo investigate the demand, supply and satisfaction of the Chinese people on assistive technology. MethodsBased on the data from the World Health Organization rapid Assistive Technology Assessment (rATA) questionnaire in six provinces and cities in China, the assistive technology of the whole population in China was described from three aspects of demand, supply and satisfaction. ResultsA total of 15 234 valid questionnaires were obtained. In terms of demand, the proportion of visual impairment was the highest in all the functional impairment categories, the highest demands in the list were glasses (low-vision, short/long distance etc.) and walking sticks (canes/sticks, tripod and quadripod), while the highest demand outside the list was anti-skid pad. In terms of supply, the private sector was the main one, followed by government facility and public hospital, and most users took "paid out-of-pocket (self)" to obtain assistive technology, the distance to access the assistive technology was concentrated at "less than five kilometers", and the biggest obstacle to obtain assistive technology was lack of knowledge about assistive technology. Overall satisfaction with assistive technology was optimistic, the adaptation degree and service quality of assistive technology were the most unsatisfactory factors for users. ConclusionIn China, the satisfaction of assistive technology is optimistic, and there is a few amount of unmet assistive technology. It is necessary to propagandize assistive technology, and its manual should be readable, the assistive technical service team should be multidisciplinary, enterprises should promote independent innovation, and the professionals should be regulated.

Nicotinamide Mononucleotide Adenylyl Transferase 2 Inhibition Aggravates Neurological Damage after Traumatic Brain Injury in a Rat Model

Objective@#: Nicotinamide mononucleotide adenylyl transferase 2 (NMNAT2) is a crucial factor for the survival of neuron. The role of NMNAT2 in damage following traumatic brain injury (TBI) remains unknown. This study was designed to investigate the role of NMNAT2 in TBI-induced neuronal degeneration and neurological deficits in rats. @*Methods@#: The TBI model was established in Sprague-Dawley rats by a weight-dropping method. Real-time polymerase chain reaction, western blot, immunofluorescence, Fluoro-Jade C staining, and neurological score analyses were carried out. @*Results@#: NMNAT2 mRNA and protein levels were increased in the injured-side cortex at 6 hours and peaked 12 hours after TBI. Knocking down NMNAT2 with an injection of small interfering RNA in lateral ventricle significantly exacerbated neuronal degeneration and neurological deficits after TBI, which were accompanied by increased expression of BCL-2-associated X protein (Bax). @*Conclusion@#: NMNAT2 expression is increased and NMNAT2 exhibits neuroprotective activity in the early stages after TBI, and Bax signaling pathway may be involved in the process. Thus, NMNAT2 is likely to be an important target to prevent secondary damage following TBI.

Comparison of the performance of two methods to determine set-up errors for DIBH patients with left sided breast cancer in radiotherapy / 中华放射肿瘤学杂志

Objective:To establish the basic procedures of the application of optical surface monitoring system (OSMS) in the deep inspiration breath hold (DIBH) radiotherapy for patients with left sided breast cancer and compare the performance of OSMS and cone-beam CT (CBCT) in the determination of the set-up errors of DIBH radiotherapy for patients with left sided breast cancer.Methods:Twenty patients with left sided breast cancer received DIBH radiotherapy. Through the registration of CBCT images with the planning CT images, and the registration of OSMS radiography images with the outer contour of the body surface, translational set-up errors and rotational errors were determined along the lateral-medial ( Rx), superior-inferior ( Ry) and anterior-posterior ( Rz) directions. Pearson correlation analysis was performed to evaluate the correlation of the set-up errors determined by two methods, and Bland- Altman plot analysis was used to assess the coincidence of these two methods. Results:Two methods were positively correlated. The Rz volume was 0.84, 0.74 and 0.84 in the x, y and z directions, and 0.65, 0.41 and 0.54 in the Rx, Ry and Rz directions, respectively (all P<0.01). The 95% CI of agreement were within preset 5 mm tolerance (-0.37-0.42cm, -0.39-0.41cm, -0.29-0.49cm ) in x, y and z directions for two methods. The 95% CI of agreement were within preset 3 ° tolerance -2.9°-1.4°, -2.6°-1.4°, -2.4°-2.5°in Rx, Ry and Rz directions for two methods. The system errors of 20 patients with left sided breast cancer receiving DIBH radiotherapy were <0.18cm and the random errors were <0.24cm. Conclusions:OSMS is equivalent to CBCT in the determination and stimulation of set-up errors for patients with left sided breast cancer receiving DIBH radiotherapy. The combination of CBCT and OSMS is a safe and reliable method.

Analysis of the inter-and intra-fraction setup errors and residual errors during stereotactic radiotherapy for brain metastasis / 中华放射肿瘤学杂志

Objective To evaluate the necessity of arc by arc setup verification in patients with brain metastases receiving stereotactic radiotherapy (SRT) by analyzing the inter-and intra-fraction setup errors and residual errors collected from the ExacTrac X-ray portal image.Methods Clinical data of brain metastases patients treated with SRT in the previous two years were retrospectively analyzed.The ExacTrac X-ray setup images were collected after the normal setup procedure.Setup errors were calculated by registering the cranial bony structures of the ExacTrac X-ray setup images to that of the digitally reconstructed setup images.The inter-and intra-fraction setup errors and residual errors were statistically analyzed.Results Seventy-five patients from 116 lesions received 337 cycles of SRT of the head.The inter-and intra-fraction translational setup errors in the x,y and z directions were (0.93±0.86) mm and (0.15±0.59) mm;(1.83± 1.27) mm and (0.25±0.73) mm;(0.96±0.80) mm and (0.14±0.56) mm,respectively.The inter-and intra-fraction rotational setup errors in the x,y,z directions were (0.65°± 0.62°) and (0.19°± 0.40°);(0.97°±0.94°) and (0.13°± 0.25°);(0.92°± 0.71°) and (0.10°± 0.29°),respectively.The residual translational setup errors in the x,y,z directions were (0.06±0.23) mm,(0.08±0.24) mm and (0.08±0.22)mm,and (0.12°± 0.27°),(0.09°± 0.18°) and (0.06°± 0.19°) for the residual rotational setup errors,respectively.For a reference setup error threshold of 0.7 mm/0.7°,99.1％ of the SRT exceeded the threshold and required setup correction.For 1 006 non-coplanar arcs,rotating the treatment couch from 0° to the treatment angle made 66.4％ of arcs exceed the threshold and require at least once setup correction.Conclusions During SRT for brain metastasis,the inter-and intra-fraction setup errors should be emphasized.It is necessary to perform arc by arc setup error verification.

Comparative study of dual-source MDCT signs with pathology in renal cell carcinoma / 实用放射学杂志

Objective To analyze relationship between dual-source MDCT and pathology in renal cell carcinoma.Methods 129 patients with pathology were proved renal cell in our hospital from 2009 to 2012.According to the latest 2004 WHO pathological classification,CT features of renal carcinoma were compared with surgical and pathological results.Results The enhancement de-gree of lesions on contrast CT was correlated to the modal of renal malignant cells’ranking.There was no certain correlation be-tween integrity on the edge of the tumor in CT and pathological tumor capsular.The short-hair sign surrounding the margin of tumor strongly indicated renal capsule invasion (P <0.01).Agreement between CT-Robson staging and surgical-pathologic staging was good(Kappa=0.75).Conclusion The CT finding of renal cell carcinoma is correlated with tumor cell characteristic and inter-nal structure.Dual-source MDCT has important clinical value in the diagnosis of renal cell carcinoma.

Electron-beam irradiation therapy for keloids: retrospective study of 578 cases / 中华放射肿瘤学杂志

Objective To analyze the outcomes of radiotherapy for keloids by high energy electron beams and the factors influencing the treatment outcome.Methods From Jan 1998 to Jun 2012,846lesions in 578 patients received radiotherapy.The median age is 29 years old (range 5-80 years old).There are 841 lesions with postoperative radiotherapy and 39 lesions with skin-grafting.656 lesions treated within 1 day after operations.The max diameter of 348 keloids are ＞ 5 cm.We used 6 MeV and 7 MeV electron-beam radiation therapy.The total dose ranging from 16-18 Gy/2f (interval 1 week).Treatment fields including entire keloid scars,and any suture/puncture holes with a 1 cm-margin around the lesion were used.The skin grafting patients need radiotherapy after the flap survived (about 10-15 days after the operation).The median follow-up period was 36 months (range 8-185 months).Results There are 736 (87.0％) of 846 lesions with radiotherapy effective.Other 89 (10.5％) lesions relapse in 4-33 months (median 12 months).21 lesions were of no avail.The univarate analysis shows that keloids length,keloids location,skin-grafting,interval between operations and irradiations are the influencing factors of outcomes (P =0.007,0.000,0.000,0.001).The multivariate analysis shows that keloids location and skin-grafting remained statistically significant differences (P =0.001,0.001).Most of the recurrence cases are large and bent scars.Conclusions High-energy electron-beam radiotherapy for keloids can receive good outcomes.Treatment fields flat is very important for electron-beam radiotherapy.