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Objective:To investigate the effects of different small monitor unit (MU) beam deletion optimization method in the CyberKnife treatment planning system on the calculated planned dose to brain tumors.Methods:A total of 17 patients with brain metastases treated in our hospital from June, 2021 to February, 2022 were selected for this study. A treatment plan was designed for each patient using the multiPlan system in the CyberKnife VSI system as the group without optimization. To improve the efficiency, the generated original plans should be optimized first by deleting some small MUs, forming an experience group and an optimization group for each patient. For the experience group, beams below 30 MU were deleted according to experience. For the optimization group, beams below the MU value calculated based on the second derivative method were deleted. Finally, the parameters of the two groups were statistically compared. The main evaluation parameters included the node number, the beam number, the total number of MUs, the estimated treatment duration, doses to 2% and 95% planning target volumes (PTV D2 and PTV D95), average dose to PTV ( Dmean), average dose to brain tissue ( Dmean-Brain), conformity index (CI), new conformity index (nCI), gradient index (GI), coverage, and the maximum doses to the brainstem and left and right lens ( Dmax-BS, Dmax-LL, and Dmax-RL), and the average doses to the dose shells 20 mm and 40 mm away from PTV (Shell20 and Shell40). Results:The two optimization method met the requirements for the prescription dose delivery to more than 98% PTV. There were statistical differences in the node number ( H = 7.97, P< 0.05) and estimated treatment duration ( H = 6.60, P < 0.05) among the group without MP optimization, the experience group, and the optimization group, with the estimated treatment duration and node number of the optimization group less than those of the group without MP optimization ( P < 0.05). There were no statistically significant differences in other parameters among the three groups ( P > 0.05). The PTV was moderately positively correlated with the treatment duration ( r=0.79, P < 0.01) and beam number ( r=0.78, P < 0.01) of the experience group, and was also moderately positively correlated with the treatment duration ( r=0.69, P < 0.01) and beam number ( r=0.71, P < 0.01) of the optimization group. Conclusions:For the CyberKnife planning of heads, the small MU beam deletion optimization method based on the second derivative can further shorten the treatment duration while ensuring no significant differences in the distribution of doses to organs at risk and targets. Moreover, this method is more effective in optimizing the plans for a large PTV volume.
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Objective To investigate the effect of couch rotation angle on non-coplanar static intensity-modulated radiotherapy (IMRT) plan for gastric cancer and to provide a reference for clinical planning. Methods A retrospective analysis was conducted on patients who recently underwent postoperative IMRT for gastric cancer. Twenty patients who received radiotherapy in the centre of Radiation Oncology of Huanggang Central Hospital from August 2022 to January 2023 were selected. That were selected to receive a seven-field coplanar static IMRT plan based on a couch rotation angle of 0° as the control group. Then, based on the coplanar IMRT plan, only the couch rotation angle of gantry angles 30° and 330° was changed to 10°, 20°, 30°, 40°, 50°, 60°, 70°, 80°, and 90°, respectively, and nine different non-coplanar plans were established. The homogeneity index (HI), conformity index (CI) of the target volume, and monitor unit (MU), as well as Dmean, V20, and V30 of the left and right kidneys, Dmax, Dmean, V10, V20, and V30 of the spinal cord, and Dmax, Dmean, V10, V20, V30, and V40 of the small intestine and liver were compared among the 10 plans. The MU and the dosimetric parameters of the target volumes and When the couch rotation angle was 60°, the minimum HI and maximum CI of the target volume were 0.0714±0.0089 and 0.9271±0.0108, respectively, and the minimum MU was 438±26, with the best homogeneity and conformity in the target volume and the shortest machine treatment time (P＜0.05). When the couch rotation angle was 10°, the Dmax of the small intestine was lowest, being (4620.73±99.27) cGy. When the couch rotation angle was 60°, the Dmean of the left and right kidneys was lowest, being (1246.30±130.35) cGy and (1001.52±103.33) cGy, respectively; the V20 of the left and right kidneys was lowest, being 22.87±6.29 and 19.69±1.84, respectively; the V10 and V30 of the spinal cord were lowest, being 40.08±4.92 and 1.68±0.34, respectively (P＜0.05). Conclusion The couch rotation angle has some influence on the postoperative treatment planning for patients with gastric cancer. In the design of non-coplanar plan for gastric cancer, the couch rotation angle of 60° contributes to establishing a better radiotherapy plan.
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Objective:To reconstruct the dose of nasopharyngeal carcinoma and verify the results of the whole-process radiotherapy plan based on log files and cone beam CT (CBCT).Methods:A total of 15 patients with nasopharyngeal carcinoma who received volumetric modulated arc therapy (VMAT) with Halcyon accelerator in the Cancer Center of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from February to September 2022 were retrospectively selected. Log files and CBCT for all fractionated radiotherapy were recorded. The errors of monitor unit (MU), gantry angle, and multi-leaf collimator (MLC) leaf position per control point were analyzed. The adaptive CT (aCT) were generated according to CBCT and planned CT (pCT) using a commercial software Velocity TM, and the similarities among aCT, pCT and CBCT were analyzed. The original plan was modified from the log files and imported into the treatment planning system to calculate the delivered dose on the corresponding fractionated aCT to reconstruct the fractionated dose. And all the reconstructed doses were mapped back to pCT to obtain the cumulative dose. Theγpass ratios with criteria of 2 mm/2% and 2 mm/3% and the dose differences between the planned dose and the cumulative dose in the planning target volume (PTV) and organs at risk (OAR) were compared. Results:The root mean square (RMS) and the 95th percentile of the errors of MU, gantry angle and MLC leaf position errors were within an acceptable range. The aCT generated by Velocity TM had the anatomical structure of CBCT and the resolution, contrast, noise characteristics of pCT, which could be directly used for dose calculation. Compared with the planned dose, the changes of V 70 Gy of nasopharyngeal primary tumor (PTV nx), V 68 Gy of cervical glands (PTV nd) and V 60 Gy of planning target volume (PTV1) were -0.88%±1.91%, -2.99%±2.99% and -0.63%±0.93%, respectively, and V 40 Gy of parotid gland was increased to 2.65%±2.63%. Cumulative dose showed different degrees of PTV dose decrease ( P<0.05) and parotid dose was increased ( P<0.05). The γ pass ratio (2 mm/3%) between the cumulative dose and planned dose was 97.3%±2.7% and >95.0% in 86.7% of patients. Conclusions:Based on the log files and CBCT, the whole-process dose reconstruction of nasopharyngeal carcinoma patients can be carried out. According to the results of dose reconstruction, the radiotherapy effect of the target area and OAR can be quantitatively evaluated. In the case of high dose coverage and conformity of the original plan, the reconstruction results show that the cumulative dose coverage of the target area is decreased, whereas that of the parotid gland is increased.
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OBJECTIVE To investigate the efficacy of Methotrexate （MTX） injection combined with Mifepristone tablets in the treatment of ectopic pregnancy. METHODS A retrospective cohort study method was used to collect data on patients with ectopic pregnancy who visited the Affiliated Hospital of Chengdu University from January 1， 2013 to December 31， 2021. Control group was given MTX injection alone， and exposure group was given MTX injection combined with Mifepristone tablets. Baseline variables were balanced between the two groups using a propensity score matching （PSM）， and the outcomes of the matched cohorts were compared. RESULTS A total of 125 patients were included， involving 68 in the control group and 57 in the exposure group. After PSM， 46 cases in each group were successfully matched. There was no significant difference in the treatment response rate and the incidence of adverse drug reaction （ADR） between the exposure group and the control group， which were 73.91% and 63.04%， 21.74% and 13.04% （P＞0.05）. Compared with before treatment， serum levels of β-HCG were all significantly decreased in 2 groups after treatment （P＜0.05）； there was no significant difference in the serum level of β-HCG after treatment， the time to return to normal， the interval time of second pregnancy， second ectopic pregnancy and second intrauterine pregnancy between 2 groups （P＞0.05）. The mean diameter difference of B-ultrasound pregnancy mass before and after treatment， duration of clinical symptom remission and length of hospital stay in the exposure group were significantly higher than those in the control group （P＜ 0.05）， but drug costs during hospitalization and total hospitalization costs were not significantly increased （P＞0.05）. There were no significant difference between single-dose group and multi-dose group of MTX in the treatment response rate and the incidence of ADR （P＞0.05）. The hospitalization time， drug cost and total cost of the single dose group were significantly less than those of the multi-dose group （P＜0.05）. CONCLUSIONS MTX injection combined with or without Mifepristone tablet can both effectively treat ectopic pregnancy， with comparable efficacy and safety. MTX single-dose regimen is similar to the multi-dose regimen in efficacy， but the multi-dose regimen increases the hospital stay and hospitalization costs.
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The proton treatment control system is the supporting software of the proton therapy device, which specifically coordinates and controls the status and work of each subsystem. In this study, the software architecture and hardware implementation of the proton treatment control system was developed and built a foundation for the overall debugging. Using C# programming language and WPF programming techniques, TCP network communication protocol specified by the proton treatment technical document and MVVM pattern in Windows system, the logic design and implementation of each level were studied. Meanwhile, the communication interface between the subsystems under TCP communication protocol was agreed. The logic design and research of the setup field and treatment field were carried out. And the User Interface was designed and developed using the above technology. The program realizes the communication and interaction between the proton treatment control system and each subsystem, so as to control and monitor the whole treatment process. The proton treatment control system provides a software basis for the remote overall debugging and on-line monitor and control of proton treatment device.
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Prótons , Interface Usuário-Computador , Software , Computadores , LógicaRESUMO
Objective To evaluate the clinical efficacy and safety of simultaneous enhanced accelerated radiation therapy for brain metastases (SMART-Brain) combined with functional area protection. Methods SMART-Brain was planned for 60 patients with multiple brain metastases. Using the whole brain intensity modulation technique, important functional areas such as hippocampus were protected against irradiation by delivering a dose of 30 Gy in 10 fractions. Meanwhile, a high dose of 40 Gy was delivered to brain metastases in 10 fractions. All patients were followed up to evaluate the efficacy, incidence of adverse reactions, median overall survival (OS), and intracranial progression-free survival (IPFS). Results The effective rate was 73.33% (44 cases), the disease control rate was 91.67% (55 cases), median OS was 15.2 months, and IPFS was 12 months. The 1 and 2-year OS was 66.7% and 26.4%, and the 1-year IPFS was 46.7%. The MMSE scores at 1, 3, and 6 months after SMART showed no significant differences compared with baseline scores (P > 0.05). Grade 2 and above inner ear damage such as otitis media, hearing loss, and dizziness was absent. Conclusion Smart-Brain can significantly reduce the treatment time and better protect the organs at risk, and serves as an economical, safe, and effective radiotherapy regimen in areas with limited technical conditions.
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Objective:To analyze the influence of tracking error of Xsight lung tracking system caused by cardiac beating.Methods:48 patients with lung tumors adjacent to the heart were enrolled into this study. The tumor movement curves were collected by the Xsight lung tracking system and recorded in the treatment log files during the Cyberknife treatment process. The curves were subject to filtering analysis and the respiratory motion of < 1 Hz and the cardiac beating motion of > 1 Hz were separated. According to the filtering results, the patient treatment tracking data were divided into two groups based on whether the cardiac beating wave of >1 Hz existed. The tracking errors were statistically compared between two groups based on the X-ray imaging data collected by Xsight lung tracking system during treatment.Results:For the fractionation with cardiac beat information, the tracking errors of the patient′s related models were (1.45 ± 0.99), (0.46 ± 0.21) and (0.70 ± 0.54) mm in the left-right, superior-inferior and anterior-posterior direction, respectively. For the fractionation without cardiac beat information, the tracking errors of the patient′s related models were (1.52 ± 1.17), (0.63 ± 0.37) and (1.07 ± 0.62) mm in the left-right, superior-inferior and anterior-posterior direction, respectively. The tracking errors in the superior-inferior and anterior-posterior direction of patients with accurate cardiac beat models were 28.34% and 34.86% less than those of their counterparts without accurate cardiac beat models and there was significant difference (both P<0.05). Conclusion:The tracking accuracy of Xsight lung tracking system will be significantly improved if the cardiac beat model is accurately established.
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Objective To compare the dosimetric characteristics of non-coplanar and coplanar field technology in static intensity-modulated radiotherapy of gastric cancer patients, so as to provide a reference for clinical radiotherapy plan selection. Methods Thirty-six patients with gastric cancer were selected to receive intensity-modulated radiotherapy in Huanggang Central Hospital, which was designed plan A and B. Group A used 7-field coplanar technology, while Group B used 7-field non-coplanar technology. We compared the differences of the optimized monitor unit, the dosimetry of organs at risk and target areas between group A and group B. Results Both group A and B could meet the requirements of doctors. The homogeneity index (0.14 ± 0.02), the conformity index (0.98 ± 0.01), Dmin (4315.21 ± 16.74) cGy、Dmean (4679.28 ± 28.39) cGy and Dmax(4952.30 ± 33.26) cGy of target areas in group B were better than those of group A. Moreover, the monitor unit of group B was much lower than that of group A, and the difference was statistically significant (P < 0.05). The Dmax, Dmean, V15, V20 and V30 of the left and right kidneys in group B were lower than those of group A. The Dmax (3408.57 ± 46.03) cGy, Dmean (1250.32 ± 14.27) cGy and V20 (44.91% ± 6.67%) of spinal cord and the Dmax (3408.57 ± 46.03) cGy, Dmean (1720.55 ± 17.42) cGy, V20 (25.31% ± 7.78%) and V30 (18.52% ± 1.56%) of small intestine were also lower than those of group A. The differences were statistically significant (P < 0.05). Conclusion The non-coplanar field radiation plan has more advantages in terms of target dose distribution and protection of organs so that it can be more considerably used in the process of planning and design.
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Bronchial asthma is characterized by airway inflammation, bronchial hyperresponsiveness, and recurrent episodes of reversible airway obstruction. Due to different pathophysiological mechanisms, the disease is very heterogeneous in clinical manifestation, course of disease, response to treatment, phenotype etc. There is a strong need for biomarkers to assess the characteration and severity of the disease. Recently, lymphocyte and blood cells, antibodies, cytokines, chemokines, noncoding RNA and other protein markers have been studied as blood biomarkers of asthma. The present article summarized these biomarkers in diagnosis, phenotyping and treatment efficacy.
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Food specific IgG antibody detection has been widely carried out at home and abroad in recent years. The controversial issues mainly focus on whether the test is applicable to the diagnosis of allergic diseases, whether it has clear clinical significance, the relevant description in the international allergy guidelines, and the mechanism of action. This paper mainly discussed the above issues, summarized the clinical applicability of food specific IgG antibody detection.
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Objective:To investigate the application of equivalent uniform dose (EUD) in the combination of intracavitary and interstitial brachytherapy (combined-BT) for cervical cancer.Methods:Twenty cervical cancer patients treated with combined-BT in Tianjin Medical University Cancer Institute and Hospital were recruited in this study. For each patient, treatment plans were optimized based on EUD and hybrid EUD (h-EUD). The results were statistically compared with predefined plans generated by Oncentra Brachy v4.3 using hybrid inverse planning optimization (HIPO). Furthermore, virtual uniform interstitial experiments were applied to evaluate the advantage of EUD.Results:All three plans showed consistent conformity index. Compared with the HIPO plans, the average D 2cm 3 of bladder, rectum and intestine in the EUD plans were decreased by 0.22 Gy, 0.23 Gy and 0.28 Gy, and those in the h-EUD plans were declined by 0.16 Gy, 0.22 Gy and 0.24 Gy, respectively. The average EUD of bladder, rectum and intestine in the EUD plans were decreased by 0.14 Gy, 0.20 Gy and 0.15 Gy, and those in the h-EUD plans were declined by 0.20 Gy, 0.13 Gy and 0.16 Gy, respectively (all P<0.05). The virtual interstitial experiment showed EUD could significantly improve the dose sparing for organs at risk (OARs). Conclusion:The application of EUD can significantly improve the dose sparing for normal tissues without compromising dose homogeneity and conformity during combined-BT for cervical cancer.
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Objective To study the clinical use of indocyanine green (ICG) fluorescence imaging in laparoscopic liver surgery.Methods The clinical and pathological data of 68 patients who underwent laparoscopic hepatectomy using the ICG fluorescence imaging technique during the study period from September 2016 to October 2018 in Zhongnan Hospital,Wuhan University were retrospectively analyzed.Analysis was carried out on the surgical methods,fluorescence navigation methods,ICG injection time and dose,tumor characteristics,and pathological studies of the resected specimens.Results Of 68 patients,3 patients were converted to open surgery,and the remaining 65 patients completed the ICG fluorescence laparoscopic hepatectomy.Thirty-two of these 65 patients underwent ICG fluorescent guided laparoscopic anatomical resection of lower hepatic segment / hepatic hemilivers (positive staining in 17 patients,negative staining in 15 patients),with 19 patients successfully staining with ICG(19 / 32,59.4％).Postoperative histopathology showed primary hepatic solid tumors (n=31),secondary liver tumors (n=12),hepatic cysts (n=4),hepatic hemangiomas (n =5),hepatolithiasis (n =12) and hepatic focal nodular hyperplasia (n =1).These lesions were combined with hepatitis B liver fibrosis in 29 patients.Conclusions ICG fluorescence imaging positively impacted on laparoscopic liver surgery.Proper preoperative ICG injection was helpful for the identification,localization and intraoperative surgical guidance of tumors,especially for patients with deep-seated and central tumors.As a consequence,oncological and surgical safety of laparoscopic liver surgery was improved.Targeted visualization of liver segments and surgical navigation using intraoperative ICG injections facilitated accurate and precise resection of anatomical liver segments or hemi-hepatectomies.The use of intraoperative ICG fluorescence technology for hepatic hemangioma,hepatic cyst,intrahepatic bile duct stones and other benign liver lesions,helped to improve safety of surgery.
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Objective To compare the dosimetric differences of the targets and the OARs in rectal cancer patients between Auto-planning and intensity-modulated radiotherapy (IMRT),and explore the advantages of Auto-planning (AP).Methods A total of 10 postoperative radiotherapy rectal cancer patients were selected,whose CT images were used to create AP plan and IMRT plan respectively using Pinnacle3 9.i0 treatment planning system.Through comparing the dose-volume histograms of the two plan types,the differences of the homogeneity index,conformity index and the doses to organs at risk (OARs) were analyzed.Results The AP plans were significantly better (t=-1.36,-3.03,0.37,P＜0.05) in terms of higher D Dmin and lower Dmax.But the differences in D2,Dg5,D98 were insignificant (P＞ 0.05).In the AP plan,the HI values of the target area were significantly reduced,and the CI values were significantly increased (t =1.24,0.10,P＜ 0.05).Significant superior results were found in V40,V50 of bladder,V30,V45,V50 of small intestine,V30,V40 of left and right femoral head (t=-3.21-1.02,P＜ 0.05).AP plans achieved insignificantly lower V30,V45 in bladder,V4o in small intestine and V45 in left and right femoral head than IMRT plan (P＞0.05).Conclusions Compare with IMRT plans,the AP plans for rectal cancer can achieve better homogeneity index,effectively reduce the maximum dose,increase the minimum dose,reduce hot and cold volumes in the target area.Meanwhile,AP plans can also protect the normal tissues better by reducing the dose to the OARs.
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Objective To investigate the 25-hydroxy-vitamin D[25(OH)D] and vitamin D binding protein ( VBDP) levels in critically ill children admitted to PICU,their clinical significance and the relation-ship with prognosis. Methods Two hundred and ninty-five children with critical illness admitted to PICU from February 2015 to July 2016 were enrolled as subjects( study group) and 44 healthy controls were recrui-ted. Serum 25(OH)D and VDBP levels were measured on the 1st and 7th day of PICU,then clinical data were collected for statistical analysis. Results (1) Among subjects,there were no statistically significant differ-ences in the incidences of 25(OH)D deficiency and VDBP decline(P>0. 05). (2)The levels of 25 (OH)D and VDBP in the study group were lower than those in the control group [ ( 61. 38 ± 29. 42 ) nmol/L vs. (97. 11 ± 30. 11) nmol/L; (514. 36 ± 211. 13)μmol/L vs. (840. 82 ± 448. 96)μmol/L,respectively,P <0. 05]. (3) There were no significant differences in the level of VDBP ,28-day mortality,organ failure rate and mechanical ventilation rate among 25(OH)D adequate group(n=85),inadequate group(n=97) and deficient group( n=113 ) ( P>0. 05 ) . The duration of PICU stay,PRISMⅢscores were significantly longer and higher (P<0. 05) in 25(OH)D inadequate group or deficient group than those of 25(OH)D adequate group.(4) Compare to the 7th day ,the levels of 25(OH)D and VDBP were lower (P <0.05) and PRISM Ⅲscores was higer on the 1st day in the cases staying in PICU≥7 d[ (71. 14 ± 31. 78)nmol/L vs. (60.65 ±30.77)nmol/L;(532.23 ±148.49)μmol/L vs. (484.73 ±128.17)μmol/L;2.0(0.0 ～5.0) scores vs. 5. 0(3. 0～8. 0)scores,respectively,P<0. 05]. (5) Among the 295 cases of critically ill children ,the 28-day mortality was 12. 9％(38/295),the death patients showed lower 25(OH)D status[ (51. 17 ± 29.65)nmol/L vs. (62.89 ±29.15)nmol/L,P <0.05] and higher PRISM Ⅲ score[ 8.5(5.0 ～14.3) scores vs. 4. 0(1. 0～7. 0) scores,P<0. 05 ]than those of the survival. Conclusion (1)The prevalences of 25(OH)D and VDBP insufficient and deficiency among critically ill children are high. (2) Patients with 25(OH)D insufficiency and deficiency show a poorer prognosis than those with sufficient 25(OH)D. (3) The change of 25(OH)D status is not completely consistent with the VDBP.
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Objective To measure the actual absorbed dose of the target in the QUASAR Respiratory Motion Phantom using the CyberKnife Synchrony Respiratory Tracking System, and to evaluate the effect of density heterogeneity on the absorbed dose of tumor gross target volume ( GTV ) . Methods Nine groups were obtained by making different patterns of QUASAR phantom:rib thickness of 0, 20, and 50 mm, and motion amplitudes of 0, 10, and 15 mm. The nine groups were treated with static computed tomography (CT) in different time phases of four-dimensional CT (4DCT) plan, with the same beam and number of monitor units, and the 4D accumulated dose was calculated. The doses of static and 4D plans were calculated using Ray-tracing and Monte Carlo algorithms, and the absorbed doses of GTV in the nine groups were measured at the same time. Results There were a decrease in calculated absorbed dose of GTV and an increase in deviation between the planned and actual dose, with the increases in simulated rib thickness and motion amplitude. Conclusions The density heterogeneity has an impact on the absorbed dose of GTV. Both static CT and 4DCT plan can evaluate the absorbed dose of GTV in case of small rib thickness and motion amplitude, and 4DCT plan with Monte Carlo algorithm may be the optimal method for evaluation of the absorbed dose of GTV in case of large rib thickness and motion amplitude ( deviation<3%)
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Objective: To observe the efficacy of icalutamide and goserelincombined with paclitaxel (albumin bound) and prednisone in patientswith intermediate and advanced prostate cancer.Methods: One hundred patients with intermediate and advancedprostate cancer were randomly divided into control group (n = 50)and observation group (n = 50). The patients in the control groupwere treated with oral bicalutamide and goserelin acetate sustainedrelease.The patients in the observation group were treated with oral bicalutamide, goserelin acetate sustained-release, paclitaxel (albumin bound) andprednisone. After 3 cycles of treatment, the effects and adverse reactions were compared.Results: The complete remission rate and the partial remission rate of the observationgroup were higher than those in the control group (22.0% vs 8%, 60% vs 40%, both P 0.05).Conclusion: The endocrine therapy combined with paclitaxel (albumin bound) and prednisonein patients with intermediate and advanced prostate cancer can achieve good efficacy.
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Objective To design the control system of a magnetic resonance image (MRI) navigated pneumatic surgical robot. Method The driven system of the robot was constructed by combining with pneumatically driven and ultrasonic motor. The cylinder position control loop was established based on proportion integration differentiation (PID) control. The mathematical model of the pneumatic servo system was established by system identification. The PID parameter tuning and the simulation of the system characteristics were conducted. The stability analysis was conducted using the Nyquist criterion, and the acupuncture accuracy and the magnetic compatibility of the robot were verified. Results The simulation results showed that the maximum steady-state error was about 0.4 mm and the maximum tracking error was less than 2 mm, indicating that the PID control system had high control precision and trajectory tracking ability. The error of the acupuncture accuracy test was 0.72 mm. The results of water-modeling experiments showed that the magnetic resonance images were clear indicating that the influence of the robot on the MRI images was small. Conclusions The results of imulation, acupuncture and water-modeling tests showed that the pneumatic robot system can meet the requirements of brachytherapy surgery.
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Objective To investigate the clinical efficacy of bromhidrosis with botulinum toxin A by needle free injection.Methods A total of 40 patients with bromhidrosis were collected and divided into needle free group and needle group.A comparative study was carried out in those subjects.Patients in needle free group received needle free injection of botulinum toxin A by INJEX30;Needle group received traditional injection by 26 G needles.Results In needle free group,16 cases were cured,3 cases were effective,1 case was ineffective,no significant pain,hematomas or necrosis were found.In needle group,15 cases were cured,4 cases were effective,and 1 case was ineffective;localized hematoma occurred in 2 cases.And cases in group needle experienced pain more intensely than cases in needle free group.Conclusions The INJEX30 improves the security,comfort and therapy compliance of botulinum toxin A injection in the bromhidrosis patients,with similar efficacy with traditional injection.
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Objective To establish HPLC determination method and impurity profile of the related substances in metronidazole.Methods A Welch Ultimate(R)XB-C1s (4.6 mm× 250 mm,5 μm)was used with a mobile phase consisting of methanol-1.36 g· L-1 solution of potassium dihydrogen phosphate (20∶ 80).The detection wavelength was 315 nm and the flow rate was 1 mL· min-1.Its related substances were determined by principal component self-contrast method.Results Good separation of metronidazole and the impurities could be achieved.Twenty batches of samples in the past six years were determined which meet quality standards.The study of impurity profiles could effectively monitor the synthetic process and the change of impurities in metronidazole.Conclusion The method is simple,quick and sensitive,which can be used to control the related substances in metronidazole.Meanwhile,the impurity profiles ensure the quality stability of metronidazole.
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Objective To investigate the relieving effect of acupuncture plus medication on persistent right upper abdominal and scapular pains during acute exacerbation of chronic cholecystitis.Method One hundred patients with acute exacerbation of chronic cholecystitis were randomly allocated to treatment and control groups, 50 cases each. The control group received medication and the treatment group, acupuncture at points Yanglingquan, Dannang and Taichong in addition. Both groups were treated once daily, for a total of seven days. Liver function indicators (alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GGT), total bilirubin (TBIL) and direct bilirubin (DBIL)) were measured and the VAS score was recorded in the two groups before and after treatment. The clinical therapeutic effects were compared between the three groups.Result There were statistically significant pre-/post-treatment differences in the liver function indicators and the VAS score in the three groups (P<0.05). There were statistically significant post-treatment differences in TBIL and DBIL, and the VAS score between the treatment and control groups (P<0.05). The total efficacy rate was 98% in the treatment group and 50% in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusion Acupuncture plus medication can effectively relieve the pain induced by acute exacerbation of chronic cholecystitis and improve the liver function indicators in the patients.