医用直线加速器是用于放射性治疗的大型设备,设备的故障诊断与智能运维是保障其安全可靠运行的关键.研究设备服役过程中零部件及控制系统故障对治疗效果的影响,给出故障排除与解决方法.总结设备运行过程中的故障形式,给出故障排除方法及注意事项.制定医用直线加速器的维护方法与管理制度,明确设备智能运维过程中存在的问题与挑战,为设备的健康监测与智能运维提供参考,保证设备利用效率与治疗效果,提高放射性治疗水平.

Abstract Background: This study will explore the association between tumor necrosis factor α (TNF-α) and uterine fibroids (UFs). Methods: We will retrieve electronic databases in Cochrane Library, PUBMED, EMBASE, Web of Science, WANGFANG, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure from inception to the present. All potential case-controlled studies investigating the association between TNF-α and UFs will be included in this study. Two researchers will independently select literature, appraise study quality, and extract outcome data. We will utilize a fixed-effects model or a random-effects model to synthesize outcome data. All data analysis will be performed by RevMan 5.3 software. Results: The present study will supply high-quality synthesis and/or descriptive analysis of the recent evidence to explore the association between TNF-α and UFs. Conclusion: This study will exert evidence to determine whether or not TNF-α is associated with UFs. Study registration number: INPLASY202070010.

Background: This study will explore the association between tumor necrosis factor alpha (TNF-alpha) and uterine fibroids (UFs). Methods: We will retrieve electronic databases in Cochrane Library, PUBMED, EMBASE, Web of Science, WANGFANG, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure from inception to the present. All potential case-controlled studies investigating the association between TNF-alpha and UFs will be included in this study. Two researchers will independently select literature, appraise study quality, and extract outcome data. We will utilize a fixed-effects model or a random-effects model to synthesize outcome data. All data analysis will be performed by RevMan 5.3 software. Results: The present study will supply high-quality synthesis and/or descriptive analysis of the recent evidence to explore the association between TNF-alpha and UFs. Conclusion: This study will exert evidence to determine whether or not TNF-alpha is associated with UFs. Study registration number: INPLASY202070010.

目的 对CT影像引导下125I放射性粒子植入对恶性肿瘤患者治疗的临床疗效进行探讨研究.方法 方便选择吉林市第二人民医院放疗科于2014年2月—2015年2月收治的采用CT影像引导下行放射性粒子植入对恶性肿瘤患者24例,均在CT引导下经皮穿刺植入125I粒子进行放疗,并结合CT技术对患者手术疗效情况,统计患者生存情况、肿瘤大小变化、治疗效果分级情况等.结果 125I粒子的植入成功率为100%,19例肿瘤缩小或消失;术中有1例患者出现穿刺道少量出血、1例患者出现血气胸的情况;术后患者出现疼痛缓解10例;术后1~6月内进行CT复查,所有患者的肿瘤体积均有不同程度的缩小,而缩小50%以上的患者14例.结论 CT能够对氟脱氧葡萄糖代谢活性较高的肿瘤病灶进行显示,从而有利于肿瘤范围的估计,具有较高的准确率,CT影像引导下行放射性粒子植入用于恶性肿瘤患者治疗安全有效,疗效满意.

CT影像引导下经皮肺穿刺活检术虽然提升了肺癌临床诊断水平，但是部分患者不可避免地会出现气胸、出血等并发症，尤其一些病灶内血运丰富、有肺不张或液化坏死区的患者，难以获取满意的标本。增强CT的应用能够避开危险区域而直接定位于病灶实质，可提高满意标本的获取率、减少并发症，而越来越被临床工作者所提倡，是一项精确可靠的诊断方法，并在实践中获得良好的临床效果。

Objective This paper analyses and probes the purpose is of Syphilis Serological detection method are analyzed, and according to luetic transmission way and harm are expounded in this paper, in order to reduce the possibility of trans_mission and infection of syphilis disease, for the future of syphilis cure work provided for reference of the experience. Methods The data of syphilis patients were reviewed and analyzed, and the TRUST, RPR and TPPA were used to compare the 3 methods. Results There was no significant difference between the RPR method and TRUST method, TPPA method and ISA EL method (P>0.05); TRUST method and TPPA method, RPR method and TPPA method had significant difference (P<0.01). The detection results of different detection methods have different significance for the diagnosis of syphilis in dif_ferent periods. Conclusion Syphilis is a common disease, which can cause the harm of multiple organs and nervous system of the human body, which will seriously affect the life safety of the patients. In recent years, along with the development and the spread of syphilis disease, this disease into growth trend, as a doctor, we should do a good job of Syphilis Serological detection. Only in this way will reduce and reduce the spread of syphilis disease.

Objective To study the cancer antigen 125, AFP, serum carcinoembryonic antigen joint detection of three tumor markers for the diagnosis of clinical common female malignant tumor.Methods 60 cases of female patients with malignant tumor were chosen from 2013 to February 2015 in our hospital for medical treatment, for malignant tumor group, 60 patients with benign diseases of female were chosen on the same period in our hospital for medical treatment, for benign lesion group, control group included 60 cases of healthy people, CEA and AFP, CA125 of three groups of people was detected.Results CEA, AFP, CA125 levels of malignant tumor group were (25.71±8.39) ng/ml, (101.21±27.86)ng/ml, (260.11±79.75) U/ml, which was significantly higher than normal value, was higher than the healthy group and benign lesions group, the difference was statistically significant (P<0.05). CEA, AFP, CA125 alone for endometrial cancer, breast cancer, PPV, accuracy, speciifcity and sensitivity of the detection result of ovarian cancer was signiifcantly lower than the result of joint detection, especially sensitive of combined detection was signiifcantly higher than detected separately, which were 87.15%, 85.02%. ConclusionSerum cancer antigen 125, AFP, carcinoembryonic antigen joint detection of three tumor markers for the diagnosis of clinical common female malignant tumor value is obvious, should be widely used in clinic.

目的:对比观察三维适形放疗与常规体外放疗治疗复发性宫颈癌的疗效及远期并发症发生情况,寻找治疗复发性宫颈癌的更有效的方法.方法:选取2010年6月～2013年6月我院收治并诊断为宫颈癌治疗后复发的62例患者作为研究对象,将其随机分成对照组和研究组,每组31例.对照组患者采用常规体外放射治疗,研究组患者采用三维适形放射治疗.观察治疗后的疗效以及患者的远期并发症情况.结果:经过治疗后,研究组的总有效率为90.32％,对照组的总有效率为66.67％,研究组的总有效率明显的高于对照组的总有效率;研究组的直肠反应明显的低于对照组,而对于骨髓抑制和膀胱反应这两类并发症的发生状况,研究组和对照组之间没有显著的差异.结论:三维适形放疗治疗与常规体外放疗治疗比较,能够提高总体有效率,降低直肠反应的发生率,提高患者的治疗后的生存质量,值得推广及应用.

Objective To evaluate the clinical value and efficacy of transcatheter preoperative superselective arterial embolization in sacral or ilium tumors.Methods The procedures of superselective arterial embolization with gelfoam were performed in 15 cases. The lesions included giant cell tumor of bone (n = 5) , aneurysmal bone cyst (n = 2) ,chordoma (n = 2) , metastatic tumor (n = 4)and chondrosarcoma (n = 3) . The operations of resection were done 1 to 5 days after superselective arterial embolization.Results Angiograms showed marked reduction (80% or more) of the tumor's staining after embolization. In this series ,the average blood loss was 1100 ml ,during operations(aranged from 500 ml to 2600 ml),and all tumors were completely resected.Conclusion Preoperative transcatheter selective arterial embolization is an effective and safe method in reducing blood loss during operations and improving therapeutic effect for sacroiliac tumors.

Objective:To explore the better therapeutic method in treating upper gastrointestinal hemorrhage for portal hypertension in liver cirrhosis.Methods:109 patients, who underwent percutaneous transhepatic variceal embolization (PTVE) plus partial splenic embolization (PSE) from 1990 to 2006, were retrospectively analyzed in this study. All these enrolled patients were firstly subjected to PTVE and, if effective, received PSE subsequently,with a median follow-up of at least one year.Results:Of the 109 patients, 96 had no reoccurrence of hemorrhage within 1 years, in which 78 were under the efficiently control of hemorrhage as well as hypersplenism within 3 years.Conclusion:Currently, this combined modality therapy is the best clinical choice for the treatment of such severe complications in patients with liver cirrhosis.

Objective To explore the better therapeutic method in treating upper gastrointestinal hemorrhage for portal hypertension in liver cirrhosis.Methods Retrospective analyzed 539 cases patients from 1990 to 2006.Among them,199 cases received medicine hemostasis,32 cases received transjugular intrahepatic portal-systemic stenting shunt(TIPSS),123 cases performed breakdown or shunt operation,76 cases treated with endoscopy loop ligature,109 cases performed double interventional therapy,which combined percutaneous transvenous embolization(PTVE) with partial splenic embolization(PSE).Results There were 17 cases without cure effect,39 cases experienced rehaemorrhagia within 1 year of 199 cases who received medicine hemostasis.The endoscopy loop ligature was used in acute bleeding only,and it had a poor long term result.The clinical mortality of surgery operation was more than 50%.One year after TIPSS,the incidence rate of rehaemorrhagia for stent narrowed or blocked were 15 cases(46.88%),and the hepatocerebral disease were 7 cases(21.88%).After double interventional therapy,96 cases(88.07%) within 1 year,78 cases(71.56%) within 3 years had no rehaemorrhagia,and the hypersplenism was controlled validly also.Conclusion The double interventional therapy is the better clinical choice in treating upper gastrointestinal hemorrhage for portal hypertension in liver cirrhosis.The different embolism agent has different effect on liver function.Using morrhuate sodium could get good clinical effect.

Objective To evaluate the X-ray diagnosis of thoracolumbar vertebral compression fracture.Methods Retrospectively analyze the X-ray appearance and clinical materials of thoracolumbar vertebral compression fracture in 56 cases.Results The normal vertebral shape disappeared differently,the density of bone decreased and the fragment of the fractured verbebral centrum distended around the vertebra.The fracture of the vertebral accessories(pedicle of vertebral arch became wide or narrow)compressed the vertebral canal and caused the vertebral canal narrow,the joint disturbance or dislocation of vertebral superior and inferior articular process,protrusion of intervertebral disc,and the spinal cord compressed.Conclusion Good plain X-ray can display the vertebral column clearly and can diagnose the thoracolumbar vertebral compression fracture correctly.

目的:探讨迷路炎致突发性耳聋的螺旋CT三维重建成像技术的临床应用。方法:采用薄层螺旋扫描技术(小视野Fov=5cm,层厚1.0mm),进行最小密度投影法(MinIP)、最大密度投影法(MIP)、多层面重组(MPR)和表面重建(SSD)各种方法的三维重建。结果:采用MinIP,MPR及SSD能充分显示骨性迷路,耳蜗,前庭,前、后、外三个骨性半规管,膜性迷路,蜗管(2.5周),球囊,椭圆囊,前、后、外三个膜性半规管的表面、分布形态及内部结构和病变密度、范围、形态、边缘情况。结论:螺旋CT三维成像技术能充分准确观测内耳迷路内部和表面的立体结构,并能充分显示病变范围、形态、密度、边缘情况。

目的探讨肝海绵状血管瘤的介入治疗方法及效果。方法对我院收治的肝海绵状血管瘤患者30例,应用介入方法施行肝动脉插管,并注入平阳霉素与超液化碘油混合乳剂,术后6个月进行随访,观察肿瘤大小、临床症状的改善情况及不良反应。结果 30例介入患者,肿瘤完全消失者8例,瘤体缩小者20例,瘤体无变化者2例;有效率达100%,未见不良反应的情况发生。结论肝海绵状血管瘤通过介入治疗效果显著,具有安全、简便、微创、费用低、成功率高、并发症少等优点,是肝血管瘤治疗的一种理想疗法,值得推广。

肝硬化门脉高压症(CPH)是临床常见疾病,食管及胃底静脉曲张破裂大出血是门脉高压症较多见的严重并发症之一,严重者危及生命.因内、外科治疗效果差,目前胃冠状静脉、胃短静脉栓塞和部分性脾动脉栓塞(PSE)的双介入治疗在国内已得到广泛的开展,公认为是治疗CPH首选的治疗手段.