Introduction: Breast cancer is the most common cancer in women. The treatment of breast carcinoma has advanced in the last decade and nowadays there are treatment protocols for all stages of the disease. Depending on ...Introduction: Breast cancer is the most common cancer in women. The treatment of breast carcinoma has advanced in the last decade and nowadays there are treatment protocols for all stages of the disease. Depending on the histopathology and stage breast cancer is treated with surgery, chemotherapy and radiotherapy. Regarding radiation, the field of irradiation includes the chest wall in patients with mastectomy, or the breast glandular tissue in patients with conserving surgical approaches. It is often treated with radiation therapy with two opposing tangential fields, and when indicated supraclavicular lymph nodes have to be irradiated. In this case an additional anterior field is applied. The tangential as well as the other radiation beams have a potential damaging effect on the healthy surrounding tissues, particularly over the heart in the left breast irradiation and in the lungs as well. Material and Methods: The study included 25 patients with left breast carcinoma, all post surgery, treated with radiation therapy, with the Elekta accelerator at our department. For academic purpose the treatment plans were generated following two methods. The first one with two tangential opposite beams plus a supraclavicular beam. In this method the angles of the tangential internal and external create an angle that is equal to 180˚{310˚& 130˚};no further changes were made to the beam geometry. Even though this is not the best option from the dose distribution point of view, it is still the most applied method, probably because of the semplicity of it. For each patient, a second plan was generated using two opposite tangential beams plus the supraclavicular beam. The angles of the internal and external beam were changed from 1˚to 3˚, depending on the surface of the body, so that the resulting angle was 180˚± 3˚{310˚± 3˚& 130˚± 3˚} with the aim to adapt the beam geometry as much as possible to the shape of the thoracic wall and to spare the OAR-s. Results and Discussion: The data show that the dose in the organs at risk, in terms of dose percentage, is lower when the angles of the beams are changed with 1˚- 3˚, compared to the classic method where the internal and external angles equal 180˚. This dose is not only non-negligible but significant;for every angle change from 1˚to 3˚, there is a significant reduction in the integral dose in the radiated volume, expressed in percentage, up to 5%. Conclusion: In most centers, the radiation treatment of breast is realized with two tangential opposite beams, which usually are mirror beams, or in other words, the internal and external beam angles create an angle of 180˚{α + β = 180˚}. This is a simple method, which provides a good dose distribution, but leaves a relatively high dose in the organs at risk. This study shows the difference in the dose percentage in the heart and lung when the beam angles are changed adapting to the anatomy of the patient. Reducing these doses allows for better overall treatment and less longtime toxicity, particularly for the heart tissues.展开更多
Fei Xiaotong’s(Fei Hsiao-tung)works on rural economies and societies written in the 1940s were deeply affected by British economic historian R.H.Tawney.Through comparison,this article reveals at least two connections...Fei Xiaotong’s(Fei Hsiao-tung)works on rural economies and societies written in the 1940s were deeply affected by British economic historian R.H.Tawney.Through comparison,this article reveals at least two connections between their works.First,Tawney’s analysis of the transition from agricultural modernization to industrial modernization in Britain serves as a reference for Fei’s works on the economic transformation of the Yangtze Valley in Jiangsu and Lucun village in Yunnan.Second,Tawney’s“theory of gentry”also serves as the underlying view for Fei’s theory on the functions of the Chinese gentry.However,Fei does not simply follow Tawney’s steps.Instead,he offers unique insights into the issues of horticulture transformation and gentry types in China.Furthermore,in Fei’s social theory and practice,the role of“state”was considered to be less positive.The interrelations of the community,market,intellectuals and the state construct Fei’s modernization scheme of China.His idea about how China,a slower participant in the world system,can maintain economic autonomy was still valuable today.展开更多
In the last chapter of Jane Austen's third novel, Mansfield Park, Fanny Price, the heroine, married her cousin Edmund Bertram. In the context of British society in the early 19th century, Fanny's marriage had ...In the last chapter of Jane Austen's third novel, Mansfield Park, Fanny Price, the heroine, married her cousin Edmund Bertram. In the context of British society in the early 19th century, Fanny's marriage had a strong symbolic meaning:through mar-riage, Fanny was legally accepted by Mansfield Park;at the same time, she was also given an opportunity to temporarily escape from the oppression from the parents of Mansfield Park (although she could never escape from the control offeudal system);the ac-ceptance of Fanny was a reflection of the efforts of the gentry (represented by Sir Thomas Bertram, Edmund's father) to ameliorate slavery when it was declining.展开更多
文摘Introduction: Breast cancer is the most common cancer in women. The treatment of breast carcinoma has advanced in the last decade and nowadays there are treatment protocols for all stages of the disease. Depending on the histopathology and stage breast cancer is treated with surgery, chemotherapy and radiotherapy. Regarding radiation, the field of irradiation includes the chest wall in patients with mastectomy, or the breast glandular tissue in patients with conserving surgical approaches. It is often treated with radiation therapy with two opposing tangential fields, and when indicated supraclavicular lymph nodes have to be irradiated. In this case an additional anterior field is applied. The tangential as well as the other radiation beams have a potential damaging effect on the healthy surrounding tissues, particularly over the heart in the left breast irradiation and in the lungs as well. Material and Methods: The study included 25 patients with left breast carcinoma, all post surgery, treated with radiation therapy, with the Elekta accelerator at our department. For academic purpose the treatment plans were generated following two methods. The first one with two tangential opposite beams plus a supraclavicular beam. In this method the angles of the tangential internal and external create an angle that is equal to 180˚{310˚& 130˚};no further changes were made to the beam geometry. Even though this is not the best option from the dose distribution point of view, it is still the most applied method, probably because of the semplicity of it. For each patient, a second plan was generated using two opposite tangential beams plus the supraclavicular beam. The angles of the internal and external beam were changed from 1˚to 3˚, depending on the surface of the body, so that the resulting angle was 180˚± 3˚{310˚± 3˚& 130˚± 3˚} with the aim to adapt the beam geometry as much as possible to the shape of the thoracic wall and to spare the OAR-s. Results and Discussion: The data show that the dose in the organs at risk, in terms of dose percentage, is lower when the angles of the beams are changed with 1˚- 3˚, compared to the classic method where the internal and external angles equal 180˚. This dose is not only non-negligible but significant;for every angle change from 1˚to 3˚, there is a significant reduction in the integral dose in the radiated volume, expressed in percentage, up to 5%. Conclusion: In most centers, the radiation treatment of breast is realized with two tangential opposite beams, which usually are mirror beams, or in other words, the internal and external beam angles create an angle of 180˚{α + β = 180˚}. This is a simple method, which provides a good dose distribution, but leaves a relatively high dose in the organs at risk. This study shows the difference in the dose percentage in the heart and lung when the beam angles are changed adapting to the anatomy of the patient. Reducing these doses allows for better overall treatment and less longtime toxicity, particularly for the heart tissues.
基金The paper was the research result of the“Study on the Theory and Methodology of the Rural Social Transformation by the Yanching School”(18BSH001)a general project under the National Social Science Foundation of China.Thoughts on the paper were initially formed in the“Shiheng Excellent Lecture”sponsored by Yunnan Shiheng Education Foundation in the summer of 2016.
文摘Fei Xiaotong’s(Fei Hsiao-tung)works on rural economies and societies written in the 1940s were deeply affected by British economic historian R.H.Tawney.Through comparison,this article reveals at least two connections between their works.First,Tawney’s analysis of the transition from agricultural modernization to industrial modernization in Britain serves as a reference for Fei’s works on the economic transformation of the Yangtze Valley in Jiangsu and Lucun village in Yunnan.Second,Tawney’s“theory of gentry”also serves as the underlying view for Fei’s theory on the functions of the Chinese gentry.However,Fei does not simply follow Tawney’s steps.Instead,he offers unique insights into the issues of horticulture transformation and gentry types in China.Furthermore,in Fei’s social theory and practice,the role of“state”was considered to be less positive.The interrelations of the community,market,intellectuals and the state construct Fei’s modernization scheme of China.His idea about how China,a slower participant in the world system,can maintain economic autonomy was still valuable today.
文摘In the last chapter of Jane Austen's third novel, Mansfield Park, Fanny Price, the heroine, married her cousin Edmund Bertram. In the context of British society in the early 19th century, Fanny's marriage had a strong symbolic meaning:through mar-riage, Fanny was legally accepted by Mansfield Park;at the same time, she was also given an opportunity to temporarily escape from the oppression from the parents of Mansfield Park (although she could never escape from the control offeudal system);the ac-ceptance of Fanny was a reflection of the efforts of the gentry (represented by Sir Thomas Bertram, Edmund's father) to ameliorate slavery when it was declining.
