Accelerated Infliximab Induction for Severe Lower Gastrointestinal Bleeding in a Young Patient with Crohn’s Disease:A Case Report

BACKGROUND Severe lower gastrointestinal bleeding(SLGIB)is a rare complication of Crohn's disease(CD).The treatment of these patients is a clinical challenge.Monoclonal anti-TNFαantibody(IFX)can induce relatively fast mucosal healing.It has been reported for the treatment of SLGIB,but there are few reports on accelerated IFX induction in CD patients with SLGIB.CASE SUMMARY A 16-year-old boy with a history of recurrent oral ulcers for nearly 1 year presented to the Gastroenterology Department of our hospital complaining of recurrent periumbilical pain for more than 1 mo and having bloody stool 4 times within 2 wk.Colonoscopy showed multiple areas of inflammation of the colon and a sigmoid colon ulcer with active bleeding.Hemostasis was immediately performed under endoscopy.The physical examination of the patient showed scattered small ulcers in the lower lip of the mouth and small cracks in the perianal area.Combined with his medical history,physical examination,laboratory examinations with high C-reactive protein(CRP),platelet count(PLT),erythrocyte sedimentation rate(ESR)and fecal calprotectin levels,imaging examinations and pathology,a diagnosis of CD was taken into consideration.According to the pediatric CD activity index 47.5,methylprednisolone(40 mg QD)was given intravenously.The abdominal pain disappeared,and CRP,PLT,and ESR levels decreased significantly after the treatment.Unfortunately,he had a large amount of bloody stool again after 1 wk of methylprednisolone treatment,and his hemoglobin level decreased quickly.Although infliximab(IFX)(5 mg/kg)was given as a combination therapy regimen,he still had bloody stool with his hemoglobin level decreasing from 112 g/L to 80 g/L in a short time,so-called SLGIB.With informed consent,accelerated IFX(5 mg/kg)induction was given 7 days after initial presentation.The bleeding then stopped.Eight weeks after the treatment,repeat colonoscopy showed mucosal healing;thus far,no recurrent bleeding has occurred,and the patient is symptom-free.CONCLUSION This case highlights the importance of accelerated IFX induction in SLGIB secondary to CD,especially after steroid hormone treatment.

Optimizing beam transport in rapidly compressing beams on the neutralized drift compression experiment-II

The Neutralized Drift Compression Experiment-II(NDCX-II)is an induction linac that generates intense pulses of 1.2 MeV helium ions for heating matter to extreme conditions.Here,we present recent results on optimizing beam transport.The NDCX-II beamline includes a 1-m-long drift section downstream of the last transport solenoid,which is filled with charge-neutralizing plasma that enables rapid longitudinal compression of an intense ion beam against space-charge forces.The transport section on NDCX-II consists of 28 solenoids.Finding optimal field settings for a group of solenoids requires knowledge of the envelope parameters of the beam.Imaging the beam on the scintillator gives the radius of the beam,but the envelope angle is not measured directly.We demonstrate how the parameters of the beam envelope(radius,envelop angle,and emittance)can be reconstructed from a series of images taken by varying the B-field strengths of a solenoid upstream of the scintillator.We use this technique to evaluate emittance at several points in the NDCX-II beamline and for optimizing the trajectory of the beam at the entry of the plasma-filled drift section.

Effects of Three Typical Resistivity Models on Pulsed Inductive Plasma Acceleration Modeling

The effects of three different typical resistivity models（Spitzer, Z＆L and M＆G） on the performance of pulsed inductive acceleration plasma are studied. Numerical results show that their influences decrease with the increase of the plasma temperature. The significant discriminations among them appear at the plasma temperature lower than 2.5 eV, and the maximum gap of the pulsed inductive plasma accelerated efficiency is approximately 2.5%.Moreover, the pulsed inductive plasma accelerated efficiency is absolutely related to the dynamic impedance parameters, such as voltage, inductance, capacitance and flow rate. However, the distribution of the efficiency as a function of plasma temperature with three resistivity models has nothing to do with the dynamic impedance parameter.

Commissioning of Dragon-Ⅰ Linear Induction Accelerator

This paper describes the subsystems commissioning process of Dragon-Ⅰ which include the injector,the pulsed power system,the transport system and the Bremsstrahlung target.The experimental results and further work are presented.

Monte Carlo simulations for 20 MV X-ray spectrum reconstruction of a linear induction accelerator

To study the spectrum reconstruction of the 20 MV X-ray generated by the Dragon-I linear induction accelerator, the Monte Carlo method is applied to simulate the attenuations of the X-ray in the attenuators of different thicknesses and thus provide the transmission data. As is known, the spectrum estimation from transmission data is an ill-conditioned problem. The method based on iterative perturbations is employed to derive the X-ray spectra, where initial guesses are used to start the process. This algorithm takes into account not only the minimization of the differences between the measured and the calculated transmissions but also the smoothness feature of the spectrum function. In this work, various filter materials are put to use as the attenuator, and the condition for an accurate and robust solution of the X-ray spectrum calculation is demonstrated. The influences of the scattering photons within different intervals of emergence angle on the X-ray spectrum reconstruction are also analyzed.

Acceleration modules in linear induction accelerators

The Linear Induction Accelerator （LIA） is a unique type of accelerator that is capable of accelerating kilo-Ampere charged particle current to tens of MeV energy. The present development of LIA in MHz bursting mode and the successful application into a synchrotron have broadened LIA＇s usage scope. Although the transformer model is widely used to explain the acceleration mechanism of LIAs, it is not appropriate to consider the induction electric field as the field which accelerates charged particles for many modern LIAs. We have examined the transition of the magnetic cores＇ functions during the LIA acceleration modules＇ evolution, distinguished transformer type and transmission line type LIA acceleration modules, and re-considered several related issues based on transmission line type LIA acceleration module. This clarified understanding should help in the further development and design of LIA acceleration modules.

Time-resolved energy spectrum measurement of a linear induction accelerator with the magnetic analyzer

We recently set up a time-resolved optical beam diagnostic system. Using this system, we measured the high current electron beam energy in the accelerator under construction. This paper introduces the principle of the diagnostic system, describes the setup, and shows the results. A bending beam line was designed using an existing magnetic analyzer with a 300 mm-bending radius and a 60° bending angle at hard-edge approximation. Calculations show that the magnitude of the beam energy is about 18 MeV, and the energy spread is within 2%. Our results agree well with the initial estimates deduced from the diode voltage approach.

Conception design of helium ion FFAG accelerator with induction accelerating cavity

In the recent decades of particle accelerator R＆D area, the fixed field alternating gradient （FFAG） accelerator has become a highlight for some advantages of its higher beam intensity and lower cost, although there are still some technical challenges. In this paper, the FFAG accelerator is adopted to accelerate a helium ion beam on the one hand for the study of helium embrittlement on fusion reactor envelope material and on the other hand for promoting the conception research and design of the FFAG accelerator and exploring the possibility of developing high power FFAG accelerators. The conventional period focusing unit of the helium ion FFAG accelerator and three- dimensional model of the large aperture combinatorial magnet by OPERA-TOSCA are given. For low energy and low revolution frequency, induction acceleration is proposed to replace conventional radio frequency （RF） acceleration for the helium ion FFAG accelerator, which avoids the potential breakdown of the acceleration field caused by the wake field and improves the acceleration repetition frequency to gain higher beam intensity. The main parameters and three-dimensional model of induction cavity are given. Two special constraint waveforms are proposed to refrain from particle accelerating time slip （AT） caused by accelerating voltage drop of flat top and energy deviation. The particle longitudinal motion in two waveforms is simulated.

Axial electric wake field inside the induction gap exited by the intense electron beam

While an intense electron beam passes through the accelerating gaps of a linear induction accelerator, a strong wake field will be excited. In this paper a relatively simple model is established based on the interaction between the transverse magnetic wake field and the electron beam, and the numerical calculation in succession generates a magnetic wake field distribution along the accelerator and along the beam pulse as well. The axial electric wake field is derived based on the relation between field components of a resonant mode. According to some principles in existence, the influence of this field on the high voltage properties of the induction gap is analyzed. The Dragon-I accelerator is taken as an example, and its maximum electric wake field is about 17 kV/cm, which means the effect of the wake field is noticeable.

Instantaneous electron beam emittance measurement system based on the optical transition radiation principle

One kind of instantaneous electron beam emittance measurement system based on the optical transition radiation principle and double imaging optical method has been set up. It is mainly adopted in the test for the intense electron-beam produced by a linear induction accelerator. The system features two characteristics. The first one concerns the system synchronization signal triggered by the following edge of the main output waveform from a Blumlein switch. The synchronous precision of about 1 ns between the electron beam and the image capture time can be reached in this way so that the electron beam emittance at the desired time point can be obtained. The other advantage of the system is the ability to obtain the beam spot and beam divergence in one measurement so that the calculated result is the true beam emittance at that time, which can explain the electron beam condition. It provides to be a powerful beam diagnostic method for a 2.5 kA, 18.5 MeV, 90 ns （FWHM） electron beam pulse produced by Dragon I. The ability of the instantaneous measurement is about 3 ns and it can measure the beam emittance at any time point during one beam pulse. A series of beam emittances have been obtained for Dragon I. The typical beam spot is 9.0 mm （FWHM） in diameter and the corresponding beam divergence is about 10.5 mrad.

Experimental comparison of various techniques for spot size measurement of high-energy X-ray sources

In flash-radiography experiments, the quality of the acquired image strongly depends on the focal size of the X-ray source spot. A variety of techniques based on imaging of the pinhole, the slit and the rollbar are adopted to measure the focal spot size of the Dragon-I linear induction accelerator. The image of the pinhole provides a two-dimensional distribution of the X-ray spot, while those of the slit and the rollbar give a line-spread distribution and an edge-spread distribution, respectively. The spot size characterized by the full-width at half-maximum and that characterized by the LANL definition are calculated for comparison.

Spot size diagnostics for flash radiographic X-ray sources at LAPA

Spot size is one of the parameters to characterize the performance of a radiographic X-ray source. It determines the degree of blurring due to magnification directly. In recent years, a variety of measurement methods have been used to diagnose X-ray spot size at Laboratory of Accelerator Physics and Application (LAPA). Computer simulations and experiments showed that using a rolled-edge to measure the spot size are more accurate, and the intensity distribution of X-ray source was obtained by a device with a square aperture. Experimental and simulation results on a flash X-ray source at our laboratory are presented and discussed in this paper. In addition, a new method for time resolved diagnostics of X-ray spot size is introduced too.

Conceptual design of an intense positron source based on an LIA

Accelerator based positron sources are widely used due to their high intensity. Most of these accelerators are RF accelerators. An LIA （linear induction accelerator） is a kind of high current pulsed accelerator used for radiography. A conceptual design of an intense pulsed positron source based on an LIA is presented in the paper. One advantage of an LIA is its pulsed power being higher than conventional accelerators, which means a higher amount of primary electrons for positron generations per pulse. Another advantage of an LIA is that it is very suitable to decelerate the positron bunch generated by bremsstrahlung pair process due to its ability to adjustably shape the voltage pulse. By implementing LIA cavities to decelerate the positron bunch before it is moderated, the positron yield could be greatly increased. These features may make the LIA based positron source become a high intensity pulsed positron source.

Spot size measurement of a flash-radiography source using the pinhole imaging method

The spot size of the X-ray source is a key parameter of a flash-radiography facility, and is usually quoted as an evaluation of the resolving power. The pinhole imaging technique is applied to measure the spot size of the Dragon-I linear induction accelerator, by which a two-dimensional spatial distribution of the source spot is obtained. Experimental measurements are performed to measure the spot image when the transportation and focusing of the electron beam are tuned by adjusting the currents of solenoids in the downstream section. The spot size of full-width at half maximum and that defined from the spatial frequency at half peak value of the modulation transfer function are calculated and discussed.