The feasibility and safety of high-intensity focused ultrasound combined with low-dose external beam radiotherapy as supplemental therapy for advanced prostate cancer following hormonal therapy

The aim of this study was to investigate the feasibility and safety of high-intensity focused ultrasound （HIFU） combined with （＋） low-dose external beam radiotherapy （LRT） as supplemental therapy for advanced prostate cancer （PCa） following hormonal therapy （HT）. Our definition of HIFU＋LRT refers to treating primary tumour lesions with HIFU in place of reduced field boost irradiation to the prostate, while retaining four-field box irradiation to the pelvis in conventional-dose external beam radiotherapy （CRT）. We performed a prospective, controlled and non-randomized study on 120 patients with advanced PCa after HT who received HIFU, CRT, HIFU＋LRT and HT alone, respectively. CT/MR imaging showed the primary tumours and pelvic lymph node metastases visibly shrank or even disappeared after HIFU ＋LRT treatment. There were significant differences among four groups with regard to overall survival （OS） and disease-specific survival （DSS） curves （P=0.018 and 0.015）. Further comparison between each pair of groups suggested that the long-term DSS of the H IFU ＋ LRT group was higher than those of the other three groups, but there was no significant difference between the HIFU＋LRT group and the CRT group. Multivariable Cox＇s proportional hazard model showed that both HIFU＋LRT and CRT were independently associated with DSS （P=0.001 and 0.035） and had protective effects with regard to the risk of death. Compared with CRT, HIFU ＋LRT significantly decreased incidences of radiation-related late gastrointestinal （GI） and genitourinary （GU） toxicity grade ≥ II. In conclusion, long-term survival of patients with advanced PCa benefited from strengthening local control of primary tumour and reRional lymph node metastases after HT. As an alternative to CRT, HIFU＋LRT showed Rood efficacy and better safety.

Moving Target Detection and Tracking for Smartphone Automatic Focusing

In this paper,a non-contact auto-focusing method is proposed for the essential function of auto-focusing in mobile devices.Firstly,we introduce an effective target detection method combining the 3-frame difference algorithm and Gauss mixture model,which is robust for complex and changing background.Secondly,a stable tracking method is proposed using the local binary patter feature and camshift tracker.Auto-focusing is achieved by using the coordinate obtained during the detection and tracking procedure.Experiments show that the proposed method can deal with complex and changing background.When there exist multiple moving objects,the proposed method also has good detection and tracking performance.The proposed method implements high efficiency,which means it can be easily used in real mobile device systems.

Review of Literature of the Vocabulary Acquisition Strategy——“Reading+Word-Focused Activities”

The paper isto introduce the effectivenessof the vocabulary acquisition strategy——"Reading +word-focused activities"through a review of some foreign experimental and quasi-experimental researches concerning this strategy. Meanwhile English major teachers are given some hints through this strategy to instruct their students in vocabulary learning.

Generalization of the Thermal Dose of Hyperthermia in Oncology

Hyperthermia has been a modality to treat cancer for thousands of years. During this time, intensive efforts are concentrated on determining the dose of the proper treatment, but the dominantly in vitro induced cellular death does not provide enough confidence for the clinical dosing. The cell-death by heat-monotherapy applications in laboratory experiments is difficult to apply in the complementary therapies in clinical applications. The newly developed nanotechnologies offer completely new possibilities in this field as well. Modulated electro-hyperthermia (mEHT, trade-name Oncothermia) is a nanoheating technology that has selective effects on membrane rafts and on the transmembrane proteins. This effect is thermal. The thermal action is in nanoscopic range which makes the phenomenon special. Our objective is to show the dose concept on this emerging method.

A COMPUTER SIMULATION OF HIGH-DOSE ION IMPLANTATION INTO AMORPHOUS MATERIALS

A computer program MACA was developed for simulating high-dose ion implantation into amorphous solids. The topology of amorphous solids was modelled by adjusting the free flight path distribution between collisions, so that the radial distribution function will characterize the short - range order and long - range disorder of amorphous targets. A simulation example is given.

The Current Status of the Delineation and Determination of the Targets and the Radiation Protocols for Nasopharyngeal Cancer with Intensity-Modulated Radiotherapy

IMRT has increased the local-regional control and decreased the complications from treating nasopharyngeal cancer （NPC）. Therefore studying IMRT is important. CT and MRI are complementary, and their joint use is currently considered to be the optimal modality to delineate the extent of the primary spread of NPC. The key problem in delineation of the neck nodes is how to translate anatomic node regions into the CT boundaries. The consensus guideline which narrowed the gap among different cancer centers is recommended in delineating the boundary of the cervical lymph node regions. The definition of the NPC GTV is clear and almost the same among the main cancer centers in their IMRT planning protocols. The suggested biological dose to the GTV is close to or more than 80 Gy; the main differences are the definitions of the CTVs and their schemes for the prescribed dose, and also the dosage to the high cervical region is different among those centers. According to their long-term follow-up results, it is suggested that, besides adding 5-10 mm margins to the primary lesions, the immediate high-risk structures （including the entire nasopharyngeal cavity, retropharyngeal space, clivus, base of the skull, pterygoid plates and muscles, parapharyngeal space, the sphenoid and partial ethmoid sinuses, the posterior third of the maxillary sinuses and the nasal cavity） should also be included with a prescription of more than 60 Gy, and the bilateral Ib, II and Va node levels should be ranked as high-risk regions and differentially prescribed for treatment with no less than 60 Gy.

双模态成像仿生纳米粒对甲状腺髓样癌的声动力治疗

背景:声动力疗法作为一种新型抗肿瘤治疗手段具有非侵入性和时空可控性的特点,在甲状腺髓样癌无创性治疗中具有广阔的应用前景。目的:制备具有双模态成像能力的仿生癌细胞膜涂层脂质纳米粒,检测纳米粒的理化性质、靶向能力、成像效果、细胞毒性和抗迁移能力。方法:以二棕榈酰磷脂酰胆碱、二棕榈酰磷脂酰甘油、二硬脂酰磷脂酰乙醇胺-聚乙二醇2000、胆固醇、血卟啉单甲醚、全氟己烷为原料,通过薄膜水合-超声振荡法制备脂质纳米粒HP@LNP,其中血卟啉单甲醚装载于脂质纳米结构的疏水层,全氟己烷装载于脂质纳米结构的亲水核心层内;将甲状腺髓样癌细胞膜包覆于脂质纳米粒HP@LNP表面,构建具有主动靶向甲状腺髓样癌细胞能力的仿生脂质纳米粒MHP@LNP。表征纳米粒MHP@LNP的理化性质、靶向能力、免疫逃逸能力、成像效果、细胞毒性和抗迁移能力。结果与结论:①脂质纳米粒MHP@LNP呈现典型的核壳结构,粒径为131.06 nm,平均电位为-30.59 mV,凝胶电泳结果显示脂质纳米粒MHP@LNP与癌细胞膜蛋白图谱相符合,荧光共定位结果显示脂质纳米粒MHP@LNP与癌细胞膜的荧光信号显著重合。脂质纳米粒MHP@LNP纳米粒内血卟啉单甲醚的包封率为87.8%,载药率为14.6%。在低强度聚焦超声刺激下,脂质纳米粒MHP@LNP可发生相变产生微泡,在4 min时超声信号强度达到最大值。在激光照射下,脂质纳米粒MHP@LNP的光声信号强度与其质量浓度呈现线性相关。脂质纳米粒MHP@LNP具有同源细胞靶向能力和免疫逃逸能力。未经低强度聚焦超声照射前的脂质纳米粒MHP@LNP具有良好的生物相容性,而经低强度聚焦超声照射后产生具有细胞毒性的活性氧,有效杀伤甲状腺髓样癌细胞,并抑制甲状腺髓样癌细胞的迁移能力。②结果表明,脂质纳米粒MHP@LNP能够在超声和光声双模态成像引导下实现声动力治疗,用于治疗甲状腺髓样癌。

基于Eclipse Scripting API的剂量限制结构生成系统的设计与实现

目的:开发剂量限制结构生成系统,以自动生成放疗物理师制订调强放疗计划时所需的剂量限制结构。方法:该系统利用Eclipse软件内置的应用程序开发接口Eclipse Scripting API进行开发,以Eclipse功能插件的形式运行。利用Eclipse Scripting API检索并读取调强放疗计划中计划靶区和危及器官的名称、体积等信息,并调用Eclipse软件自身的功能进行结构的新建、体积外扩和裁剪等操作,生成剂量限制结构。结果:该系统能在1.5~3.0 s内按指定条件生成危及器官计划体积、剂量缓冲区和剂量控制环等3种调强放疗计划所需的剂量限制结构,且生成的剂量限制结构外形轮廓、体积数值、颜色与手工生成的完全一致,符合功能设计要求。结论:该系统不仅简化了剂量限制结构生成操作步骤,避免了放疗物理师的重复劳动,还大幅减少了剂量限制结构生成用时,提高了制订调强放疗计划的工作效率。

CAREDose4D在鼻咽癌放疗定位中的应用

目的:探讨CARE Dose 4D技术在鼻咽癌放疗定位中的应用价值。方法:将60例拟放疗的鼻咽癌患者随机分为A组和B组,每组30例。A组管电压120 kV固定300 mAs行常规扫描,B组管电压120 kV并开启CARE Dose 4D设置预设值为500 mAs进行扫描。在这两种不同扫描方式下扫描CIRS 064M电子密度模体,验证CT-RED转换曲线是否有差异。客观评价两组图像的噪声(SD)、信噪比(SNR)、对比噪声比(CNR)、GTV的CT值、剂量长度乘积(DLP)、容积CT剂量指数(CTDI_(vol))及有效辐射剂量(ED)。并由两位高年资医师对图像进行主观评分。结果:两种扫描方式下,CT值及CT-RED转换曲线无明显差异,保证了靶区剂量计算的精确性;B组与A组比较CTDI_(vol)降低35%,DLP、ED均降低43%,差异有统计学意义(P<0.001);客观评价中两组图像的SNR、CNR、GTV的平均CT值之间的差异无统计学意义(P>0.05)。两组图像在三角肌平面,A组SD高于B组,差异有统计学意义(t=30.809,P<0.001);两组图像主观评价有显著性差异(z=-2.445,P<0.05)。A组图像中由于肩部横断面内颈部淋巴引流区噪声较大,对医生勾画该层面的靶区造成了一定困扰,从靶区勾画角度来说,B组图像要优A组。结论:在鼻咽癌放疗定位中应用CARE Dose 4D技术是可行的,可提高图像质量,同时大幅降低患者的有效辐射剂量。

3 min靶控全麻诱导插管依托咪酯血浆浓度与瑞芬太尼血浆浓度最佳配伍剂量观察

目的:探索寻找使用TCI注射泵实施3 min靶控全麻诱导的依托咪酯血浆浓度(Cp)与瑞芬太尼Cp配伍大组中抑制插管反应效果最好又无或少副作用的最佳药物浓度、配伍剂量组合。方法:选取择期实施骨科、普外科、妇科手术接受气管插管全麻的美国麻醉医师协会(ASA)分级Ⅰ级或Ⅱ级中青年患者150例,随机分为:依托咪酯Cp 1.0μg/ml、1.1μg/ml、1.2μg/ml、1.4μg/ml、1.5μg/ml分别与瑞芬太尼Cp 20 ng/ml配伍组,共5组,每组30例。先静注阿托品0.007 mg/kg,心率上升后启动TCI泵并开始计时,意识消失时静注罗库溴铵0.8 mg/kg,在TCI泵注3 min时使用Airtraq和Insighters可视喉镜气管插管。记录患者基础和插管前后平均动脉压(MAP)和心率(HR)等数据。结果:5组中,瑞芬太尼Cp 20 ng/ml配伍依托咪酯Cp 1.0μg/ml组抑制插管反应效果Ⅱ级,肌颤、肌僵发生率为零。结论:瑞芬太尼Cp 20 ng/ml配伍依托咪酯Cp 1.0μg/ml组抑制插管反应效果Ⅱ级,肌颤、肌僵发生率为零,是中青年患者使用TCI注射泵实施3 min靶控全麻诱导抑制插管反应效果最好的组,是安全的最佳药物浓度配伍剂量组合。

Use of Three Dimensional Conformal Radiation Therapy for Node Positive Breast Cancer Does Not Result in Excess Lung and Heart Irradiation

Purpose: This work evaluates the use of target and organs at risk (OAR) dose-volume goals in 3D conformal radiotherapy (3DCRT) planning for node positive breast cancer (NPBC) patients undergoing regional nodal irradiation after lumpectomy/mastectomy. Methods: Dosimetric data for 262 NPBC patients receiving regional nodal and whole breast/chest wall (WB/CW) irradiation from 2000-2009 were analyzed. In all cases, target & OAR volumes were delineated on treatment CT scans for field generation and dose-volume histograms (DVHs) were generated. Cases were analyzed to identify how frequently they met treatment planning institutional dose-volume goals (“institutional guidelines” & standardized in 2005) and how this would affect OAR doses. Results: The incidence of cases from 2000-2009 meeting current institutional guidelines improved over the study period. Target coverage improved from 2005-2009, when guidelines were followed as a part of the plan approval. Those cases from 2000-2004 meeting acceptable target goals were found to be significantly different from those cases from 2005-2009 (p < 0.01). However, no significant difference between cases meeting OAR goals for plans from 2000-2004 versus 2005-2009 was found. Conclusions: The use of institutional guidelines in 3DCRT for WB/CW and regional nodal irradiation for NPBC patients improved target coverage without a statistically significant increase in heart and lung doses.

Why is Asian Infrastructure Investment Bank So Attractive?

The target of the AIIB is to focus on supporting the infrastructure construction in Asia as well as to promote regional cooperation and partnership so that countries can jointly address the challenges during the developing process.As the first China-led multilateral international institution,AIIB is targeted for focusing on supporting the infrastructure construction

松果菊苷对6-OHDA帕金森病模型大鼠海马α-Synuclein、β-actin蛋白表达影响随机平行对照研究

[目的]观察松果菊苷对6-OHDA帕金森病模型大鼠海马α-Synuclein、β-actin蛋白表达影响。[方法]使用随机平行对照方法,将72只SPF级SD雄性大鼠适应性饲养14d,按随机数字表法分为6组,空白对照组、假手术组、模型组、松果菊苷(低、中、高剂量)组,12只/组。各组大鼠腹腔注射10%水合氯醛(30mg/kg)麻醉,固定于颅脑定位仪,消毒,沿颅顶正中线切开皮肤,钝性分离颅骨外膜,暴露大鼠颅骨前囟门;以前囟为坐标原点(大鼠脑定位立体图谱),确定前脑内侧束(MFB)坐标,MFB:前囟后4.8mm,矢状缝右侧1.2mm,硬脑下7.8mm;颅骨钻钻孔,立体定向靶点微量注射6-OHDA(2ug/uL,溶于0.1%抗坏血酸生理盐水),注射速度1uL/min,留针15min;骨蜡封闭大鼠脑部颅骨孔,消毒缝合皮肤,复制帕金森病模型,松果菊苷(低、中、高剂量)组(8 ug)、模型组(2ug);空白对照组、假手术组(与模型组等量生理盐水)。灌胃干预:复制成功模型,松果菊苷组(低20mg/kg、中40mg/kg,高80mg/kg),余各组均等体积生理盐水,1次/d,连续10d。PAGE胶蛋白电泳;免疫印迹(Western Blot,WB)法检测α-Synuclein、β-actin蛋白。[结果]模型复制48只大鼠,麻醉过度死亡3只,模型复制不成功2只,最终纳入结果分析43只,模型组10只,松果菊苷组低、中、高剂量组各11只。α-Synuclein蛋白水平假手术组、松果菊苷各组(低中高)均低于空白对照组(P<0.01);β-actin各组间无明显差异(P>0.05);α-Synuclein/β-actin假手术组、松果菊苷低剂量组、松果菊苷中剂量组、松果菊苷高剂量组均低于空白对照组(P<0.01)。[结论]松果菊苷干预帕金森病模型大鼠,可降低海马α-Synuclein表达。

Benefits and Limitations of Volumetric Modulated Arc Therapy in Treating Bilateral Breast Cancer with Regional Lymph Nodes

Purpose: The study was performed comparing dosimetric characteristics of volumetric modulated arc therapy (VMAT) and field-in-field (FiF) techniques on a patient with synchronous bilateral breast carcinoma. Methods: The patients with bilateral breast cancer treatment were included in this study. A total dose of 40.05 Gy in 15 fractions was prescribed to the Planning Target Volume (PTV) of the whole bilateral breast cancer with the supraclavicular and infraclavicular nodes, with a complementary boost of 10 Gy in 4 fractions to the surgical bed (PTVboost). For both radiotherapy techniques, several VxGy parameters were analyzed for the PTVs, together with the Conformity index (CI), the Homogeneity index (HI) and the critical organs at risk (OARs), lungs and heart. Results: The patient was treated by the VMAT technique and the daily treatment time was less than 20 minutes with daily CBCT imaging. In the VMAT plan, the PTV 95% dose covered 38.89 ± 0.81 Gy, compared to 37.26 ± 1.02 Gy in the FiF technique. The VMAT plan improved the dose homogeneity index and lower dose in lung towards high dose region. Conclusion: The study demonstrates the viability of the VMAT technique in the treatment of bilateral breast cancer. The introduced single isocentric VMAT technique is fast to deliver and it increases the dose homogeneity of the target volume with some limitations. The treatment was well tolerated, without interruption of the treatment courses caused by treatment-related toxicities.

Stereotactic radiosurgery:a“targeted”therapy for cancer

The developments of medicine always follow innovations in science and technology.In the past decade,such innovations have made cancer-related targeted therapies possible.In general,the term "targeted therapy" has been used in reference to cellular and molecular level oriented therapies.However,improvements in the delivery and planning of traditional radiation therapy have also provided cancer patients more options for "targeted" treatment,notably stereotactic radiosurgery(SRS) and stereotactic body radiotherapy(SBRT).In this review,the progress and controversies of SRS and SBRT are discussed to show the role of stereotactic radiation therapy in the ever evolving multidisciplinary care of cancer patients.

对局部晚期NPC患者进行IMRT时通过Pinnacle计划系统设置不同的最大子野数的效果

目的:探讨并分析对局部晚期鼻咽癌(NPC)患者进行调强放疗(IMRT)时通过Pinnacle计划系统设置不同的最大子野数的效果及对其放疗指标的影响。方法:选择2018年1月至2019年1月期间在广东医科大学附属医院肿瘤中心采用Pinnacle 9.8放射治疗计划系统进行IMRT计划设计的24例局部晚期NPC患者作为研究对象。在对这些患者进行IMRT前,采用Pinnacle计划系统对其放疗靶区进行逆向优化设计,将最大子野数分别设置为60、80、100、120,并依次将其命名为plan1、plan2、plan3、plan4。比较在plan1、plan2、plan3、plan4下对患者进行IMRT时其各项放疗指标,然后找出最优的最大子野数。结果:与在plan1、plan2下对这24例患者进行IMRT相比,在plan3、plan4下对其进行IMRT时其靶区的CI均更大,其靶区的HI均更小,P<0.05。与在plan3、plan4下对这24例患者进行IMRT相比,在plan1和plan2下对其进行IMRT时其PGTVnd的Dmean均更高,P<0.05。与在plan1、plan2下对这24例患者进行IMRT相比,在plan3、plan4下对其进行IMRT时其脊髓、左眼球、左晶体、右晶体、右视神经、视交叉和右侧颞叶的Dmax均更低,P<0.05。与在plan1、plan2下对这24例患者进行IMRT相比,在plan3、plan4下对其进行IMRT时其机器的总跳数更多,其治疗的时间更长,P<0.05。结论:对局部晚期NPC患者进行IMRT时,通过Pinnacle计划系统设置不同的最大子野数对其靶区的CI、HI、危及器官的照射剂量、治疗的时间等均会产生不同的影响。与在最大子野数为60、80、120的情况下对此类患者进行IMRT相比,在最大子野数为100的情况下对进行IMRT的效果最佳。

Neutron distribution and yield produced by 50 MeV/u^(18)O-ion on thick targets

Neutron energy, fluence rate, angular distributions and dose equivalent rate distributions around the thick Be, Cu, An targets bombarded by 50 MeV/u 18O-ion were measured using a threshold detector activation method. At the same time,the neutron yields of 18O-ion and the neutron emission rates in the forward direction were obtained approximately.

冬虫夏草及其近缘品中铅、镉、砷污染评价及人体健康累积风险评估方法探索

目的:对冬虫夏草及其近缘品中铅(Pb)、镉(Cd)、砷(As)的残留量进行测定,探索符合冬虫夏草及相关产品使用特点的污染评价及人体健康风险评估方法。方法:基于冬虫夏草及其近缘品中Pb、Cd、As的残留量监测数据,综合运用单因子污染指数法、尼梅罗综合指数法、金属污染指数法对冬虫夏草及其近缘品进行重金属污染评价,计算重金属日暴露量,分别采用危害指数法和更加精确的靶器官毒性剂量法对Pb、Cd、As联合暴露产生的健康风险进行累积风险评估。结果:污染评价结果说明,冬虫夏草及其近缘品中As的污染应引起关注,不同品种污染程度为冬虫夏草(繁育品)=蛹虫草<冬虫夏草(野生品)<香棒虫草<亚香棒虫草;人体健康风险评估结果表明,对于心血管和神经系统,1批冬虫夏草(野生品)全草中Pb、Cd、As联合暴露产生的累积健康风险需被进一步关注。结论:冬虫夏草及其近缘品重金属污染评价,以及人体健康风险评估方法,可为中药安全性评价及相关限量标准的制修订提供参考。

266 nm紫外弱聚焦激光触发伪火花开关研究

当前对于光触发伪火花开关的研究主要集中在使用紫外激光触发,触发物理机制普遍认为是光电发射。然而,当紫外弱聚焦激光在低电场环境中照射光电材料(靶材)时,由光电发射产生的种子电子非常有限。为了进一步揭示紫外弱聚焦激光触发物理机制,利用266 nm紫外弱聚焦激光,搭建了开关测试实验平台和种子电子测试实验平台,研究了激光能量、开关电压、气压、靶材料、触发位置对开关触发特性的影响,分析了种子电子的来源和对触发开关的贡献。研究结果表明,在阴极背面孔边缘触发时,光电发射产生的瞬发电子不是种子电子的主要来源,与烧蚀等离子有关的超快电子才是。因此,当在阴极背面孔边缘触发时,密度和熔沸点低,易烧蚀的材料更适合作为紫外弱聚焦激光触发伪火花开关的靶材。经测试,当在阴极背面孔边缘触发,工作电压为−15 kV,气压为80 Pa(氦气)时,以镁为靶材的开关能实现稳定触发导通的最低激光能量为2 mJ,远低于铜(6 mJ)和钼(8 mJ)。此外,在上述相同条件下,激光在开关阴极孔内壁触发时,触发时延和抖动分别为36.9 ns和1.41 ns,远低于在阴极背面孔边缘触发时的时延和抖动(116.4 ns和5.39 ns)。