Research progress of adaptive radiotherapy in radiotherapy of nasopharyngeal carcinoma / 国际生物医学工程杂志

Intensity-modulated radiation therapy(IMRT) is currently the main treatment method for nasopharyngeal carcinoma. During radiotherapy for nasopharyngeal carcinoma, factors such as body mass reduction, tumor regression, and organ displacement at risk can affect the precise implementation of radiation therapy. Applying adaptive radiotherapy (ART) technology to optimize the treatment plan at the appropriate timing can reduce the adverse effects caused by the above factors and enhance the accuracy of radiotherapy. There are no uniform standards for the necessity, timing, and case selection of ART. In this review, the research progress of ART in the radiotherapy of nasopharyngeal carcinoma in recent years was reviewed to provide a reference for further clinical application of ART in nasopharyngeal carcinoma.

The setup errors of thermoplastic head and shoulder molds with or without vacuum pad in HFSRT for brain metastases in the lung cancer / 中华放射肿瘤学杂志

Objective:To retrospectively analyze the setup errors of thermoplastic head and shoulder molds alone or combined with vacuum pad in hypofractionated stereotactic radiotherapy (HFSRT) for non-small cell lung cancer (NSCLC) with brain metastases.Methods:Fifty-four NSCLC patients with brain metastases who received HFSRT from 2017 to 2019 were enrolled in this study. Twenty-four patients were fixed with thermoplastic head and shoulder molds (group A), and 30 patients were fixed with thermoplastic head and shoulder molds plus vacuum pad (group B). The interfraction and intrafraction setup errors were acquired from cone-beam CT online image registration before and after the HFSRT. Optical surface system was applied in monitoring the intrafraction setup errors. The setup errors in each direction between two groups were analyzed by independent samples t-test. Results:For the interfraction setup errors of the whole group, the proportion of the horizontal setup errors of ≥3mm was 7.0% to 15.4% and 7.0% to 12.6% for the rotation setup errors of ≥2°. In group A, the anteroposterior setup error was (1.035±1.180)mm, significantly less than (1.512±0.955)mm in group B ( P=0.009). In group A, the sagittal rotation setup error was 0.665°±0.582°, significantly less than 0.921°±0.682° in group B ( P=0.021). For the intrafraction setup errors of the whole group, the proportion of horizontal setup errors of ≥1mm was 0% to 0.7%, whereas no rotation setup error of ≥1° were observed. In group B, bilateral, anteroposterior and sagittal rotation setup errors were (0.047±0.212)mm, (0.023±0.152)mm and 0.091°±0.090°, significantly less compared with (0.246±0.474)mm, (0.140±0.350)mm and 0.181°±0.210° in group A ( P=0.004, P=0.020, P=0.001), respectively. Optical surface monitoring data were consistent with the obtained results. Conclusions:Thermoplastic head and shoulder molds (with or without vacuum pad) combined with online image registration and six-dimensional robotic couch correction can be applied in HFSRT for brain metastases from NSCLC. The intrafraction setup errors in group B are smaller than those in group A. Optical surface system has certain value in monitoring the intrafractional movement.

Application of the Simodont dental trainer in preclinical manual dexterity training / 中华医学教育探索杂志

Objective:To explore the application of the Simodont dental trainer in preclinical manual dexterity training for dental students of different grades, and to discuss its effect by quantitatively evaluating their practice results.Methods:The evaluation was conducted among 118 students in the Department of Stomatology, Shantou University Medical College from Batch 2015 to Batch 2018. Each student had five different manual dexterity modules for training. Each module had three levels of difficulty and was required to be completed in 30 minutes. The assessment index included Target, Leeway Bottom and Sides, Container Bottom and Sides, which was provided by the Simodont dental trainer. The operating time (in seconds), the displacement of the dental hand pieces and the dental mirrors (in meters) were simultaneously recorded. SPSS 25.0 was used for statistical analysis.Results:For the index Target, Leeway Bottom and Sides, Container Bottom and Sides, the results showed that there was a statistical difference between students who passed pre-clinical training and who did not take the professional course ( P < 0.001). For the index Target, differences were showed among students from different grades in all modules ( P < 0.001). Conclusion:The circle module, channel module, hollow-circle module and cross-module in the Simodont dental trainer have sensitivity to discriminate the manual dexterity of different levels of dental students. The further assessment of the discrimination of the manual dexterity is required for assume-block module. The Simodont dental trainer can quantitatively measure the manual dexterity of dental students, which is important for the quantitative evaluation of dental preclinical education.

Development and application of "Dental Anatomy Learning Platform" based on WeChat small program of smart phones / 中华医学教育探索杂志

For displaying the three-dimensional (3D) digital model of teeth, we constructed a digital learning platform of "oral anatomy and physiology-tooth morphology" based on the WeChat small program of smart phones integrating teaching resources like texts, pictures, videos, three-dimensional animation and others. The textual content of tooth morphology was edited according to the Chinese textbook Oral Anatomy and Physiology (seventh edition) of the People's Health Publishing House and Wheeler's Dental Anatomy, Physiology and Occlusion. After photographing and cone beam CT scanning the tooth in vitro, JPEG file of tooth contour and DICOM file of tooth cross section were obtained. Continuous tomographic dynamic pictures of the tooth and 3D videos was presented by adopting software of Photoshop CS6, CS 3D imaging (affiliated simple software of cone beam CT), Snagit, Video Editor and Aijianji. Following steps of WeChat official website to register, develop, compose code, upgrade pictures and texts, submit to be verified and release, small program "Dental Anatomy Learning Platform" was completed and put into use. According to the survey, 90.3%(93) users believed the small program is helpful to learn Oral Anatomy and Physiology, especially in deepening the understanding of the tooth morphology and structure; 96.1%(99) users considered that the small program can be added to the classroom as a supplement, but it can't replace the textbook totally. The development of "Dental Anatomy Learning Platform" will provide methodological guidance for the development and integration of various dental teaching resources on the internet.

Development and application of "Dental Anatomy Learning Platform" based on WeChat small program of smart phones / 中华医学教育探索杂志

For displaying the three-dimensional ( 3D ) digital model of teeth , we constructed a digital learning platform of "oral anatomy and physiology-tooth morphology" based on the WeChat small program of smart phones integrating teaching resources like texts , pictures , videos , three-dimensional animation and others. The textual content of tooth morphology was edited according to the Chinese textbook Oral Anatomy and Physiology (seventh edition) of the People's Health Publishing House and Wheeler's Dental Anatomy, Physiology and Occlusion. After photographing and cone beam CT scanning the tooth in vitro, JPEG file of tooth contour and DICOM file of tooth cross section were obtained. Continuous tomographic dynamic pictures of the tooth and 3D videos was presented by adopting software of Photoshop CS6, CS 3D imaging (affiliated simple software of cone beam CT), Snagit, Video Editor and Aijianji. Following steps of WeChat official website to register, develop, compose code, upgrade pictures and texts, submit to be verified and release, small program "Dental Anatomy Learning Platform" was completed and put into use. According to the survey, 90.3％(93) users believed the small program is helpful to learn Oral Anatomy and Physiology, especially in deepening the understanding of the tooth morphology and structure;96.1％( 99 ) users considered that the small program can be added to the classroom as a supplement, but it can't replace the textbook totally . The development of "Dental Anatomy Learning Platform" will provide methodological guidance for the development and integration of various dental teaching resources on the internet.

Current status and reform of practice teaching of radiotherapy technology / 中华医学教育探索杂志

The Major of Medical Imaging Technology (Radiotherapy Technology Orientation) in West China Medical School, Sichuan University, has been devoted to training therapists, dosimetrists, and physicists in tumor radiotherapy, and it is urgently needed to improve the practice ability of interns and standardize the teaching system. In view of the current status of the practice of students in radiotherapy technology, this article analyzes and summarizes the teaching staff construction, teaching contents, teaching methods, and other aspects, finds out the problems and challenges in the current teaching system, and puts forward suggestions for practice teaching reform.

Study on Operation Status and Development Suggestions of Traditional Chinese Medicine Clinic in China / 中国医院管理

Objective To know the current status and problems of Traditional Chinese Medicine Clinic and to provide countermeasures.Methods Using literature research and statistical analysis.Results From 2008 to 2014,the number of institutions,health personnel and services of Traditional Chinese Medicine Clinic rose year by year.The Traditional Chinese Medicine Clinic was ahead of TCM-WM Clinic and Minority Clinic.The increase number and increase rate of the number of Traditional Chinese Medicine institutions,health personnel and services are more than TCM-WM Clinic and Minority Clinic.The age constitute is unbalance and the quality of personnel is different in Traditional Chinese Medicine Clinic.Conclusion The government should conduct multi-site practice.Traditional Chinese medicine clinics and other private medical institutions should have the equitable health care treatment.The development in preventive treatment of disease by TCM should be focused on.

Follow-up survey on teaching hospitals in Guangdong province after the evaluation / 中华医学教育探索杂志

Objective To investigate the effect of the evaluation on teaching hospitals affiliat-ed to medical colleges in Guangdong province. Methods Questionnaire and on on-the-spot investi-gation was conducted among 18 teaching hospitals which owned the accreditation for 2-3 years based on Guangdong provincial teaching hospital accreditation indicator system 2008 modified version. Contents of investigation included general situation,teaching condition,management and implementa-tion of teaching activities as well as medical staffs' comments and suggestions for the teaching work. SPSS 13.0 software was used for frequency analysis. Results The general situation,teaching condi-tion,management and implementation of teaching activities were improved to varying degrees after the evaluation according to results of the questionnaire. 90.0%(54/90)people thought that the overall scale of the hospital was expanded and 5.0%(3/60)people thought that the overall scale of the hos-pital was obviously reduced or marinated the original level. 11.6%(7/60)and 88.3%(53/60)people thought that medical quality of the hospital was improved or obviously improved. 60.0%(36/60)people thought that educational occupancy of the hospital was improved while 5.0%(3/60)people thought that it was unsatisfactory. 83.3%(50/60)people thought that teaching mold and infrastructures were improved while 10.0%(6/60)people thought that it was unsatisfactory. 95.0%(57/60)people thought that teaching management was improved. Due to the lack of incentives and support in teaching work, management of teaching was loose. Conclusions The teaching work of t hospitals affiliated to medical colleges in Guangdong province do persevere basically and achieve desired purposes.

Repeated CT scan in improving the reproducibility of grass tumor volume for moving target / 中华放射肿瘤学杂志

Objective To find a method to improve the range accuracy of moving target such as peripheral lung tumors, since a single CT snapshot may not be accurate during the treatment process.Methods A simple harmonic motion phantom, embedded with a cube and a circular ball, was used to simulate the tumor motion. Individualized moving targets were scanned 24 times with different amplitudes and frequencies. Then the images were fused from every 1, 2 or 3 sets of CT scans. The GTV volume variation of circular target and the length variation of the cube target along the z axis were contoured and analyzed. Results As motion amplitude increased, the maximum of both circular target volume and cube target length was increased, while the minimum of the factors was decreased. Motion frequency affected the target volume less than amplitude. For a cube target with the length of 3.3 cm at stationary phase, when motion frequencies was 20 and motion amplitude was 2 cm, the maximal length was 2. 4 times of the minimal length (5. 1 cm vs. 2. 1 cm). When it came to the cube target groups fused from every 1,2 and 3 sets of CT scans, the average length and standard deviation were (3.77 ± 1.20) cm, (4.18 ±0. 91)cm and (4.52 ±0. 59) cm, respectively. With the increase of fused scan number, targets became bigger, the standard deviation decreased, and the change of center positions was decreased. Conclusions The motion amplitude, frequency and the number of CT scans are the main factors affecting target definition, though, the optimized scanning phase is not certained. When 4DCT and respiration gating technique are not available,the efficient and practical method to solve this problem is to scan the target three or more times and fuse them in planning system, which will generate a larger, more reproducible GTV volume for moving targets.

A preliminary study on image guided hypofractionated radiotherapy for pulmonary tumor / 中国肺癌杂志

<p><b>BACKGROUND</b>Image guided radiotherapy (IGRT) is a new precise radiotherapy applied in clinic. The aim of this study is to evaluate the impact of using active breath control (ABC) and stereotactic body frame on reducing the positioning error and increasing treatment precision during radiotherapy for pulmonary cancer.</p><p><b>METHODS</b>Seven patients with pulmonary recurrences or metastasis after prior treatment were enrolled. A total number of 13 tumor targets received irradiation, with a fraction dose of 7Gy treated every other day to a total of 7 fractions. X-ray beam volume CT was done at every fraction for correction of positioning error at 3 dimensions.</p><p><b>RESULTS</b>The errors between pre-treatment positioning and treatment planning at left-right, anterior-posterior and cephalic-caudal directions were 0.30cm±0.14cm, 0.22cm±0.15cm and 0.28cm ±0.21cm, respectively. The positioning error was reduced after correction by volume CT and after treatment but the errors between pre-correction, post-correction and post-treatment had no statistical significance at all 3 directions. Eight targets had complete response, 4 targets had partial response, and 1 had no change.</p><p><b>CONCLUSIONS</b>Image guided hypofractionation radiotherapy with ABC and stereotactic body frame has the advantage of increasing radiation dose and reducing overall treatment time and radiation toxicity.</p>

Development of medical engineering in informatized hospitals / 医疗卫生装备

This article analyzes the characteristics and present situation of informatized hospital to explore the management mode and reform of medical engineering,and thus lays substantial foundation for the development of informatized hospital.