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Objective:To investigate the dosimetric effects of prone immobilization devices combined with a belly board (PIDBBs) in the intensity-modulated radiotherapy (IMRT) for gynecologic cancers.Methods:A total of 20 patients with cervical or endometrial cancer treated with radiotherapy in the Third Affiliated Hospital of Sun Yat-sen University from August 2020 to June 2021 were retrospectively analyzed. Two sets of body contours were outlined for each patient. One set of body contours did not contain the immobilization devices, and the other contour set included the immobilization devices. For each patient, doses were calculated for the two sets of contours using the same 7-field IMRT plan and were recorded as Plan without and Plan with. The dosimetric difference caused by the immobilization devices was assessed by comparing the parameter values in the dose-volume histograms (DVHs) and by plan subtraction. The Gafchromic EBT3 film and anthropomorphic phantom were used to verify the calculated doses. Results:The target coverage and average dose of Plan with were lower than those of Plan without. Specifically, the V50 Gy, V49 Gy, and Dmean of planning target volume (PTV) decreased by 19.75%, 7.99%, and 2.54% ( t = 8.96, 10.49, 22.09, P < 0.01), respectively. The V40 Gy, V30 Gy, V20 Gy, V15 Gy, and Dmean of skins increased by 51.79%, 51.05%, 45.72%, 33.63% and 10.80% ( t = -2.54, -5.63, -15.57, -24.06, -13.88, P < 0.01), respectively. Doses to other organs at risk (OARs) showed no significant differences. As indicated by the EBT3 measurements, the doses to skins of the abdomen and pelvis on the anthropomorphic phantom increased by approximately 37.24% ( t = 10.86, P<0.01). Conclusions:Although PIDBBs can effectively reduce the low dose to the small intestine, the radiation attenuation caused by them can reduce the PTV coverage of radiotherapy plans and increase the doses to abdominal and pelvic skins sharply, especially for patients requiring irradiation of the groin and perineum.
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Objective:To investigate the current state of standardized training in trauma surgeons in medical institutions in Shanghai.Methods:Questionnaire surveys, focus discussions and expert conferences were conducted to investigate the professional background, status of standardized training on trauma care knowledge, training needs and suggestions in 236 trauma surgeons in 25 Shanghai medical institutions.Results:The investigation revealed that only 59.3% (140/236) of the trauma surgeons had received a standardized training on trauma care knowledge. Of them, those who participated in the training by an international, domestic and local medical institution accounted for 26.4% (37/140), 47.1% (66/140) and 84.3%(118/140), respectively. Only 83 surgeons (70.3%) received regular training and most of them 66.3% (55/83) did in a low frequency of 1-2 times a year. Only 12.7% (15/118) of the surgeons received a training course of ≥48 classes (45 min per class) in the past 3 years. The training courses by medical institutions were mostly lectures on theoretical knowledge and training of a single skill while the simulated scenario drills accounted for less than 48.3%(57/118). The surgeons who had received a standardized training on trauma care were more likely to use their training knowledge to grade and score the patients with trauma, significantly more than those who had not( P<0.05). Conclusions:The coverage, time or frequency of standardized training on trauma care was not enough in Shanghai. The standardized training of trauma care surgeons should be strengthened in all medical institutions and be supervised by the management administration. A set of standardized materials and assessment standards for trauma care training should be formulated as soon as possible which fits the domestic conditions in China. Training bases should be established in Shanghai for standardized care of severe trauma and trauma specialists. A training system for trauma specialists should be established to promote traumatology in shanghai.
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This experimental study was aimed to construct the recombinant bisbicistronic eukaryotic expression vector containing endocrine and exocrine protein (EECP) gene associated with breast cancer and enhanced green fluorescent protein (EGFP) gene. And then we transfected it into breast cancer cells MCF-7 to detect the expression of EECP protein and study preliminary biological function of EECP gene. The EECP sequence was cloned to pBluescript II SK (+) plasmid. After restriction endonuclease reaction of pBluescript II SK(+) plasmid, the EECP fragment was cloned to pIRES2-EGFP vector forming a recombinant eukaryotic expression vector named pEECP-IRES2-EGFP. The potential vector was identified by restriction endonuclease digestion and sequencing. Correct plasmid was extracted and transfected into breast cancer cells MCF-7. The expression of EECP protein was detected by western blot analysis. Its biological function was studied by MTT and Flow-cytometry. It turns out that the recombinant eukaryotic expression vector containing EECP gene and EGFP gene was constructed successfully, and it could transfect MCF-7 cells efficiently. It can get higher expression of EECP protein and higher cell proliferation, thus providing an important and convenient tool for studying the function of EECP gene in vitro and in vivo.