Objective Radiotherapy combined with conservative surgery plays an important role in the treatment of early-stage breast cancer. Volumetric modulated arc therapy(VMAT) has been introduced into clinical practice. The p...Objective Radiotherapy combined with conservative surgery plays an important role in the treatment of early-stage breast cancer. Volumetric modulated arc therapy(VMAT) has been introduced into clinical practice. The purpose of this study was to investigate the dosimetric effects of different multileaf collimators(MLC) on VMAT radiotherapy plans for treating breast cancer.Methods Fifteen breast cancer patients who were treated using a conventional technique in our department were selected to participate in this retrospective analysis. VMAT plans based on three types of Elekta MLCs [Beam Modulator(BM) with 4-mm leaf width, Agility with 5-mm leaf width and MLCi2 with 10-mm leaf width] were independently generated for each patient. Plan comparisons were performed based on dose-volume histogram(DVH) analysis including dosimetric parameters such as the homogeneity index(HI), conformity index(CI), Dmax, Dmin, and Dmean for the planning treatment volume(PTV), in addition to dose-volume parameters for the organs at risk(OARs). The delivery efficiency of the three types of MLCs was compared in terms of the beam delivery time and the monitor units(MUs) per fraction for each plan. Results Both target uniformity and conformity were improved in plans for Agility and BM MLC compared with the plan using MLCi2. The mean HI decreased from 1.14 for MLCi2 to 1.13 for BM and 1.10 for Agility, while the mean CI increased from 0.68 for MLCi2 to 0.73 for BM and 0.75 for Agility. Furthermore, at both low and high dose levels, smaller volumes of ipsilateral lung, heart, contralateral lung, and breast were irradiated with Agility MLC than with the other two types of MLCs. The delivery time with Agility MLC was reduced by 10.8% and 32.1%, respectively, compared with that for MLCi2 and BM.Conclusion Our results indicate that the Agility MLC exhibits a dosimetric advantage and a significant improvement in delivery efficiency for the treatment of breast cancer using VMAT.展开更多
The article is based on collection of small terrestrial mammals(Soriculus nigrescens,Episoriculus caudatus, Neodon sikimensis,Alticola stoliczkanus, Niviventer eha and Ochotona roylei) collected in the Barun Valley, e...The article is based on collection of small terrestrial mammals(Soriculus nigrescens,Episoriculus caudatus, Neodon sikimensis,Alticola stoliczkanus, Niviventer eha and Ochotona roylei) collected in the Barun Valley, east Nepal in the pre-monsoon period of 1973.Zoogeographic and ecological characteristics and altitudinal stratification of these species are analysed, depending both on abiotic(geomorphological and climatic) and biotic(vegetation, and human presence and activities)factors. All the captured mammals were examined for ecto- and endoparasities. Infestations of Trombiculid mites and Ixodid ticks were tightly linked to the local habitat where these ectoparasites must survive during their nonparasitic phase. Analysis of their occurrence completes the reconstruction of migration routes during the expansion of small mammals into the Barun Valley and the exacerbating influence of human activities(summer pasturing,mountaineering expeditions and trekking parties).An indicator of anthropogenic influence was the occurrence of synantropic flies. The potential medical importance of these findings is discussed.It is assumed a possible occurrence of arboviruses transmitted by ticks and also rickettsioses(transmitted by ticks and chigger mites). As far bacteriological infections, plague cannot be excluded.展开更多
The first humans （hominids） appeared at about the same geological time in three independent areas： in East Africa, southern Indochina and in the Kazakh steppe. People inhabiting all continents and countries around ...The first humans （hominids） appeared at about the same geological time in three independent areas： in East Africa, southern Indochina and in the Kazakh steppe. People inhabiting all continents and countries around the world descended from hominids that emerged in these three foci then resided elsewhere. The number of people emerged 2-3 million years ago now about 7.0 billion people. They inhabit the planet and the master space. Kazakh steppe, located in the middle of the Eurasian continent, has always had a positive impact on neighboring countries. According to historical geological data obtained in the south near the ridge Karatau, the first people emerged on the territory of Kazakhstan were found about 2 million years ago. Such a conclusion was made on the basis of residual cultural pebble tools of hominids, founded by scientists. As a result of geological survey work carried out in the 1960＇s there were found some primitive people, starting with the era of＂Arystandy culture＂ and including the Late Paleolithic era in the area of ridges Big and Small Karatau. There had been found the fossil remains of large mammals hunted by hominids around the sites of ancient people. Thanks for these residues the corresponding time of residence of primitive people can be judged from the animal world of the Kazakh steppe.展开更多
文摘Objective Radiotherapy combined with conservative surgery plays an important role in the treatment of early-stage breast cancer. Volumetric modulated arc therapy(VMAT) has been introduced into clinical practice. The purpose of this study was to investigate the dosimetric effects of different multileaf collimators(MLC) on VMAT radiotherapy plans for treating breast cancer.Methods Fifteen breast cancer patients who were treated using a conventional technique in our department were selected to participate in this retrospective analysis. VMAT plans based on three types of Elekta MLCs [Beam Modulator(BM) with 4-mm leaf width, Agility with 5-mm leaf width and MLCi2 with 10-mm leaf width] were independently generated for each patient. Plan comparisons were performed based on dose-volume histogram(DVH) analysis including dosimetric parameters such as the homogeneity index(HI), conformity index(CI), Dmax, Dmin, and Dmean for the planning treatment volume(PTV), in addition to dose-volume parameters for the organs at risk(OARs). The delivery efficiency of the three types of MLCs was compared in terms of the beam delivery time and the monitor units(MUs) per fraction for each plan. Results Both target uniformity and conformity were improved in plans for Agility and BM MLC compared with the plan using MLCi2. The mean HI decreased from 1.14 for MLCi2 to 1.13 for BM and 1.10 for Agility, while the mean CI increased from 0.68 for MLCi2 to 0.73 for BM and 0.75 for Agility. Furthermore, at both low and high dose levels, smaller volumes of ipsilateral lung, heart, contralateral lung, and breast were irradiated with Agility MLC than with the other two types of MLCs. The delivery time with Agility MLC was reduced by 10.8% and 32.1%, respectively, compared with that for MLCi2 and BM.Conclusion Our results indicate that the Agility MLC exhibits a dosimetric advantage and a significant improvement in delivery efficiency for the treatment of breast cancer using VMAT.
文摘The article is based on collection of small terrestrial mammals(Soriculus nigrescens,Episoriculus caudatus, Neodon sikimensis,Alticola stoliczkanus, Niviventer eha and Ochotona roylei) collected in the Barun Valley, east Nepal in the pre-monsoon period of 1973.Zoogeographic and ecological characteristics and altitudinal stratification of these species are analysed, depending both on abiotic(geomorphological and climatic) and biotic(vegetation, and human presence and activities)factors. All the captured mammals were examined for ecto- and endoparasities. Infestations of Trombiculid mites and Ixodid ticks were tightly linked to the local habitat where these ectoparasites must survive during their nonparasitic phase. Analysis of their occurrence completes the reconstruction of migration routes during the expansion of small mammals into the Barun Valley and the exacerbating influence of human activities(summer pasturing,mountaineering expeditions and trekking parties).An indicator of anthropogenic influence was the occurrence of synantropic flies. The potential medical importance of these findings is discussed.It is assumed a possible occurrence of arboviruses transmitted by ticks and also rickettsioses(transmitted by ticks and chigger mites). As far bacteriological infections, plague cannot be excluded.
文摘The first humans （hominids） appeared at about the same geological time in three independent areas： in East Africa, southern Indochina and in the Kazakh steppe. People inhabiting all continents and countries around the world descended from hominids that emerged in these three foci then resided elsewhere. The number of people emerged 2-3 million years ago now about 7.0 billion people. They inhabit the planet and the master space. Kazakh steppe, located in the middle of the Eurasian continent, has always had a positive impact on neighboring countries. According to historical geological data obtained in the south near the ridge Karatau, the first people emerged on the territory of Kazakhstan were found about 2 million years ago. Such a conclusion was made on the basis of residual cultural pebble tools of hominids, founded by scientists. As a result of geological survey work carried out in the 1960＇s there were found some primitive people, starting with the era of＂Arystandy culture＂ and including the Late Paleolithic era in the area of ridges Big and Small Karatau. There had been found the fossil remains of large mammals hunted by hominids around the sites of ancient people. Thanks for these residues the corresponding time of residence of primitive people can be judged from the animal world of the Kazakh steppe.
