ObjectiveTo explore fibrinogen (Fbg) variety in the patients wounded in Lushan and Wenchuan earthquake. MethodsAs the research subjects, 276 Lushan earthquake victims (from April 20th to 24th, 2013) and 503 Wenchuan earthquake victims (from May 13th to 17th, 2008) were divided into five groups according to the admission date, and then the Fbg variety in those earthquake victims were analyzed. We carried out pairwise comparison among these groups in the Lushan earthquake and Wenchuan earthquake respectively on the Fbg variety. Ninety-one fracture patients in the Lushsan earthquake and 130 fracture patients in the Wenchuan earthquake were divided into two groups according to clinical diagnosis:multiple fracture and single fracture, and then we evaluated the Fbg values in patients with different degrees of disability. ResultsThe whole Fbg level[(2.70±1.15) g/L] in Lushan earthquake was below the level[(4.47±1.94) g/L] in Wenchuan earthquake, and the difference was statistically significant (P<0.01). The Fbg level in the patients whose admission date was within 48 hours was significantly different with that in patients whose admission date was more than 48 hours (P<0.01). The Fbg level in Lushan earthquake was below the level in Wenchuan earthquake, not only in the multiple fracture group but also in the single fracture group[in Lushan earthquake, the former was (2.21±0.76) g/L, and the latter was (1.98±0.85) g/L; in Wenchuan earthquake, the former was (3.35±1.48) g/L, and the latter was (3.11±1.05) g/L], and the difference was statistically significant (P<0.01). ConclusionBlood coagulation, especially Fbg level, has different degrees of changes in acute stress caused by emergency and in different treatment times, and it is better to take preventive measures.
ObjectiveTo compare the static intensity-modulated radiation therapy (IMRT) plans using different beams sets and segments number, and find the better static IMRT plan sets on beams and segments in gastric surgical adjuvant radiotherapy.MethodsFifteen patients who underwent adjuvant radiotherapy for gastric cancer between February 1st and August 30th, 2013 were chosen as subjects through random sampling. Based on the 5 beams static IMRT plans already used in clinical practice, four different static IMRT plans used diverse beams sets for each patient were designed in the same treatment planning system (Pinnacle 9.2). The beams sets of static IMRT plans were as follows: 7 coplanar equal beams; 5 coplanar equal beams; 4 coplanar beams of 310, 20, 90 and 180°; 3 coplanar beams of 310, 65 and 180°. Sufficient segments 65 was set as the max segments number in order to compare the plans’ difference just resulting from beams. In the second step, the max segments number was changed from 65 to 45 and 25 to design two different static IMRT plans for the 4 coplanar beams static IMRT plans. The dosimetric parameters were compared for the planning target volume (PTV) and organs at risk (OARs). The monitor units and treatment times of the different static IMRT plans were also evaluated.ResultsWhen the max segments number was set to 65, the 4 coplanar beams static IMRT plans were a little better on PTV conformability than the 5 coplanar beams static IMRT plans used in clinical practice (0.74±0.04 vs. 0.73±0.05, P<0.01). Meanwhile, better OARs dose sparing especially for liver and kidneys were gained by the 4 coplanar beams static IMRT plans, for example, the percent volume gained 30 Gy for liver [(22.71±6.10)%vs. (24.03±6.84)%, P<0.01] and the percent volume gained 20 Gy for the right kidney [(14.97±6.72)%vs. (19.41±6.14)%, P<0.01]. The PTV conformability of the 4 coplanar beams static IMRT plans reduced as the max segments number became smaller (0.74±0.04vs. 0.73±0.04 vs. 0.71±0.04, P<0.05). However, they were still acceptable in clinical practice. And the better dose sparing for liver and kidneys were retained. The average reductions of 1.8 and 4.3 minutes on the irradiation time were get by the 4 coplanar beams static IMRT plans with the max segments number 45 and 25 compared to that with the max segments number 65 [(494.66±26.79)vs. (384.26±14.99) vs. (235.00±9.21) s, P<0.01]. And the raises of treatment efficiency were 22.3% and 52.4%, respectively (P<0.05).ConclusionsThe 4 coplanar beams static IMRT plans with fewer segments could ensure plan quality, and protect the OARs better in the meanwhile, especially for liver and kidneys. The treatment time is reduced as well. The 4 coplanar beams static IMRT plans could improve the treatment efficiency.