Allergic conversion of protective mucosal immunity against nasal bacteria in patients with chronic rhinosinusitis with nasal polyposis

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放射性粒子治疗实体恶性肿瘤的进展

肿瘤放射治疗分外放疗和内放疗（也叫近距离治疗）。放射性粒子治疗是近距离治疗的一个重要分支。靶区勾画及处方剂量同样是粒子治疗的核心问题。国内外专家学者对不同瘤种的粒子治疗处方剂量已有相应推荐,但靶区勾画及相关定义少有报道。临床中,靶区勾画范围不精确是粒子治疗后肿瘤周边复发的主要原因。本文对几种粒子治疗常见实体恶性肿瘤亚临床病灶及外照射靶区进行描述,期望对目前粒子治疗的靶区勾画提供参考。     

脑静脉系统血栓形成典型病例临床分析

目的：对脑静脉系统血栓形成进行临床分析。方法对 CVT患者临床资料进行分析。结果早期表现均有头痛、恶心、呕吐、颅内压增高表现,且呈进行性加重、常有癫痫、伴或不伴局灶性神经功能缺失。影像学检查显示：有上矢状窦、横窦血栓形成和乙状窦、横窦血栓形成,经脱水、抗凝、溶栓等治疗患者症状明显改善。结论脑静脉窦血栓形成早期临床无特异性,头颅CT结合CTV检查对本病诊断值较高。     

脑胶质瘤适形放疗后程推量与常规放疗疗效分析

目的：为了提高脑胶质瘤适形放疗的精度，探讨提高CTV（临床肿瘤体积）勾画精度后程推量与常规放疗疗效。方法：利用现代影像技术、6-MV加速器、三维适形（X刀）放疗治疗计划系统，选择36例脑胶质瘤病例，进行脑肿瘤适形放疗后程推量与常规放疗比较。结果：经2年以上随访，3例复发率7．1％，22例肿瘤三年生存率68．5％，提高了脑胶质瘤放疗的准确性及局部控制率，降低了脑肿瘤的放疗并发症。结论：图像优化、精确勾画CTV同时选择常规分割剂量治疗，对提高脑肿瘤适形放疗的有效率和降低后期并发症有着明显的优势。     

Clinical evaluation and follow-up outcome of presurgical plan by Dextroscope: a prospective controlled study in patients with skull base tumors

Background

Patient-specific approach design, comprehensive evaluation on perioperative data, and follow-up of postoperative life quality (KPS) were carried out to evaluate the application of VR technology of Dextroscope in procedures of patients with skull base tumors.

Methods

Eighty-four patients with skull base tumors involved in this research were randomized into 2 groups (test group and control group), each with 42 patients. Before operation, image data such as MR, MRA, or CTA of head were collected and imported into the Dextroscope workstation. The detailed preoperative plans were made in the test group, but no Dextroscope plans in control group. The resection rate of tumors, preoperative evaluation including the duration of operation, total blood loss, the postoperative LOS, the number of cases with cerebrovascular injury complications in operation, and postoperative KPS of patients on discharge and the sixth month follow-up in the 2 groups were recorded and compared.

Results

The total resection rate of tumors was 83.33% in test group and 71.42% in the control group (P > .05). The total resection rate of meningioma was 86.67% in test group and 76.47% in control group. The total resection rates of trigeminal Schwannoma in the 2 groups were all 100% (P > .05). The duration of operation and the postoperative LOS of each patient were 5.25 ± 0.64 hours and 8.50 ± 1.10 days in the test group and 7.36 ± 0.87 hours and 12.50 ± 1.52 days in the control group, respectively (P < .05). Total blood loss of each patient was 456.75 ± 55.76 mL in the test group and 523.85 ± 66.78 mL in the control group (P > 05). There were 3 cases with complications of cerebral vessels injury in the test group and 7 cases in the control group (P < .05). During follow-up, KPS of patients in the test group on discharge (85.75 ± 9.68) was significantly superior to that in the control group (81.66 ± 9.24; P < .05). The KPS of patients on the sixth-month follow-up in the test group was 92.35 ± 9.95, which was significantly superior to that in the control group (85.6 ± 9.34; P < .05). Karnofsky performance scores of patients in the test group improved significantly from discharge to the sixth month after procedure (P < .05), whereas there were adverse results in the test group (P < .05). The 2 cases with CSF leakage were cured completely.

Conclusion

The preoperative plans with VR technology in patients with skull base tumor or CSF leakage operations can help certain the diagnosis, individually locate the position of skull base lesions, and design patient-specific approach, which also facilitate to shorten operation duration and the postoperative LOS, reduce total blood loss and injury of vessels in operation, and improve the postoperative KPS.     

Constrained tibial vibration does not produce an anabolic bone response in adult mice

Osteoporosis is characterized by low bone mass and increased fracture risk. High frequency, low-amplitude whole-body vibration (WBV) has been proposed as a treatment for osteoporosis because it can stimulate new bone formation and prevent trabecular bone loss. We developed constrained tibial vibration (CTV) as a method for controlled vibrational loading of the lower leg of a mouse. We first subjected mice to five weeks of daily CTV loading (0.5 G maximum acceleration) with loading parameters chosen to independently investigate the effects of strain magnitude, loading frequency, and cyclic acceleration on the adaptive response to vibration. We hypothesized that mice subjected to the highest magnitude of dynamic strain would have the largest bone formation response. We observed a slight, local benefit of CTV loading on trabecular bone, as BV/TV was 5.2% higher in the loaded vs. non-loaded tibia of mice loaded with the highest bone strain magnitude. However, despite these positive differences, we observed significantly lower measures of trabecular structure in both loaded and non-loaded tibias from CTV loaded mice compared to Sham and Baseline Control animals, indicating a negative systemic effect of CTV on trabecular bone. Based on this evidence, we conducted a follow-up study wherein mice were subjected to CTV or sham loading, and tibias were scanned at the beginning and end of the study period using in vivo microCT. Consistent with the findings of the first study, trabecular BV/TV in both tibias of CTV loaded and Sham mice was, on average, 36% and 31% lower on day 36 than day 0, respectively, compared to 20% lower in Age-Matched Controls over the same time period. Contrary to the first study, there were no differences between loaded and non-loaded tibias in CTV loaded mice, providing no evidence for a local benefit of CTV. In summary, 5 weeks of daily CTV loading of mice was, at best, weakly anabolic for trabecular bone in the proximal tibia, while daily handling and exposure to anesthesia was associated with significant loss of trabecular and cortical bone. We conclude that direct vibrational loading of bone in anesthetized, adult mice is not anabolic.     

International guideline for the delineation of the clinical target volumes (CTV) for nasopharyngeal carcinoma

Purpose

Target delineation in nasopharyngeal carcinoma (NPC) often proves challenging because of the notoriously narrow therapeutic margin. High doses are needed to achieve optimal levels of tumour control, and dosimetric inadequacy remains one of the most important independent factors affecting treatment outcome.