Based on the clinical application of ERA (easy resilient attachment), the construction of two kinds of ERA were introduced including outside-crown-EAR and root-EAR. The clinical operation and attention of EAR application were demonstrated by clinical cases.

Objective To investigate the variation in the position of conus medullaris in Chinese adult population in order to avoid hitting conus during spinal puncture. Methods Eight hundred patients suffering from back pain, aged 18-91 yr, were enrolled in this study. The position of conus medullaris was determined using Siemens 1.5 T magnetic resonance imaging system. According to the method described by Reimann, the vertebral body was used as mark of reference to the level of the end of conus. Results There were 190 patients in whom the position of the end of conus medullaris was lower than L1,2 . The incidence of the position of the end of conus medullaris lower than L1,2 was higher in patients 30-60 or older than in those under 30, and in those over the age of 60 than in those 30-60 (P ＜ 0.05). Conclusion Spinal puncture should be performed cautiously at L2,3. CT or MRI is recommended before operation for the patients to locate the position of conus medullaris and avoid injury to the spinal cord.

Objective To compare the performances of Monaco and Pinnacle treatment planning systems (TPS) for volumetric modulated arc therapy (VMAT) optimization regarding lung cancer.The TPS was compared in terms of dose distributions,treatment delivery parameters and quality control results.Methods For 20 patients,including 10 cases of left lung cancer and l0 cases of right lung cancer,two VMAT plans were generated for each case:one with Monaco 3.0 TPS and the other with Pinnacle 9.2 TPS.Two plans were compared among plan dosimetrie distribution.conformity index and homogeneity index of the targets,the average dose,maximum dose,minimum dose and interested dose volume histograms of organs at risk(OAR,and delivery time and MUs of the therapy plans,the accuracy of treatment plans dose verification.Results Monaco provided better PTV coverage than Pinnacle (t =5.927-12.034,P ＜ 0.05) except Dminof PTV.Monaco had a worse sparing effect on lung than Pinnacle (t =3.545-7.485,P ＜0.05) except V10of diseased side lung and V5of total lung.In addition,Monaco had a better sparing effect on heart(t =2.836-4.011,P ＜0.05).Monaco had fewer delivery time(t =9.780,P ＜0.05)and MUs(t =5.304,P ＜0.05)of the therapy plans,and the pass rate of QA was better than Pinnacle(t =4.937,P ＜ 0.05).Conclusions For lung cancer patients,VMAT treatment plans obtained with Monaco and Pinnacle could offer clinically acceptable dose distributions.Pinnacle might have a better sparing effect on lung and fewer delivery time and MUs of the therapy plans.Monaco had a better PTV coverage and heart sparing.Moreover,Monaco had better accuracy of treatment plans dose verification.

Objective To optimize the formulation of the sunscreen used in military training.Methods The different formulations of sunscreen were prepared according to the orthogonal design,and then applied on 3M adhesive tape posted on the color dish with a certain amount;the absorbance in 280 nm-320 nm and 320 nm-400 nm of them were measured and the arithmetic mean (A) was concluded.By comparing A,the protective effect and the main factors affecting preventive bask were determined.The preventive bask test of the optimum formula was carried out in human trials using the method of multi point increasing ultraviolet irradiation.Results OMC,TinosorbTM M,rutin,pearl powder and baicalin all had significant effects in preventing UVA.OMC had a significant effect in preventing UVB.The formula 1 (containing the five materials mentioned above) had the best effects in preventing both UVA (SPF 18) and UVB (PA+).Conclusions The formula 1 has the best effects in preventing both UVA and UVB.

Attitude to Health ; Female ; Health Policy ; Humans ; Informed Consent ; ethics ; legislation & jurisprudence ; psychology ; Male ; Singapore ; Students ; psychology ; Tissue and Organ Procurement ; ethics ; legislation & jurisprudence ; Universities ; Young Adult

Objective To study the rat pulmonary irritant of aerosol inhaled Tanreqing and Reduning injection .Methods Rats were devided into two groups for each medicine (low concentration group and high concentration group ) ,nebulized drug administration for seven days ,with the control group irrigated with saline ,and were sacrificed .Through bronchoalveolar lav-age ,excurrent bronchoalveolar lavage fluid (BALF) was used for total protein determination and LDH vitality test to evaluate pulmonary toxicity of two medicines .Results The protein concentrations of two groups in low and high concentrations of Tan-reqing and Reduning respectively are (193 .78 ± 27 .74) ,(235.33 ± 50.41)μg/ml;(174 .02 ± 17 .82) ,(227 .27 ± 66 .03)μg/ml;LDH vitalities respectively are 1065 .21 ± 181 .76 ,1467 .33 ± 101 .87;307 .97 ± 47 .56 ,1377 .29 ± 566 .48 .By t-test ,compared with normal saline ,there was no significant effect among these five groups on protein concentration ,but these two medicine were able to improve LDH activity (P<0 .05) which was more obvious in high concentration group .When two medicines were in low concentration ,LDH activity was higher in Tanreqing group with statistical significance (P<0 .05) .Conclusion Aero-sol inhaled Tanreqing and Reduning injection in rats have some pulmonary irritation and potential safety hazard in this delivery w ay .

Objective:To establish the norm of clinical nursing teachers' competency in tertiary first-class hospitals in northwest China.Methods:From August 2019 to February 2020, 1 077 clinical nursing teachers were selected from 12 tertiary first-class hospitals in northwest China by stratified, random and proportional sampling, and were investigated with the Clinical Nursing Teacher Competency Evaluation Scale. Descriptive statistics were carried out on the sample data, and univariate variance analysis and pairwise comparison were carried out on the multi-classification variables of age, nursing age, professional title, teaching years and the number of teachers per year. The verified data were exported to SPSS 26.0 for statistical analysis, variance analysis was used for multi-group comparison, and LSD test was used for pairwise comparison between groups.Results:①The corresponding mean norm was established by grouping the total score and the first-class index; the percentile norm was made with 5% spacing; P10, P30, P70 and P90 were selected as the grading demarcation points, and the demarcation norm was constructed. ②Factor analysis showed that there were statistical differences in personality characteristics among different ages, nursing ages and professional titles ( P<0.05), and also in professional attitudes among different nursing ages and professional titles ( P<0.05). Conclusion:The establishment of norm provides references for individuals or units to evaluate teachers' competence.

Objective:To establish a predictive equation for the osmolarity of parenteral nutritional prescription in China.Methods:From July 2019 to September 2019, 2 480 individualized samples of 328 different parenteral nutritional prescriptions (adult) of Peking Union Medical College Hospital were collected, and the osmolarity of parenteral nutritional solution samples was determined by a freezing point reduction method. Pearson χ2 test and a multiple linear regression analysis were utilized to establish a prediction equation for the osmolality of parenteral nutritional solution. Results:The average osmolarity of parenteral nutritional prescription was (1 164.20 ± 252.59) mOsm/kg, and the best fitting equation was (9.66A+ 7.88G+ 3.52F+ 36.4Na+ 27.55K+ 3.38P+ 7.46W-250)/V.Conclusion:The osmolarity is determined accurately and effectively by the fitting equation, which provide a benefit reference for the formulation, review and selection of clinical parenteral nutrition prescription especially in China.

Background::Bladder cancer, characterized by a high potential of tumor recurrence, has high lifelong monitoring and treatment costs. To date, tumor cells with intrinsic softness have been identified to function as cancer stem cells in several cancer types. Nonetheless, the existence of soft tumor cells in bladder tumors remains elusive. Thus, our study aimed to develop a microbarrier microfluidic chip to efficiently isolate deformable tumor cells from distinct types of bladder cancer cells.Methods::The stiffness of bladder cancer cells was determined by atomic force microscopy (AFM). The modified microfluidic chip was utilized to separate soft cells, and the 3D Matrigel culture system was to maintain the softness of tumor cells. Expression patterns of integrin β8 (ITGB8), protein kinase B (AKT), and mammalian target of rapamycin (mTOR) were determined by Western blotting. Double immunostaining was conducted to examine the interaction between F-actin and tripartite motif containing 59 (TRIM59). The stem-cell-like characteristics of soft cells were explored by colony formation assay and in vivo studies upon xenografted tumor models. Results::Using our newly designed microfluidic approach, we identified a small fraction of soft tumor cells in bladder cancer cells. More importantly, the existence of soft tumor cells was confirmed in clinical human bladder cancer specimens, in which the number of soft tumor cells was associated with tumor relapse. Furthermore, we demonstrated that the biomechanical stimuli arising from 3D Matrigel activated the F-actin/ITGB8/TRIM59/AKT/mTOR/glycolysis pathways to enhance the softness and tumorigenic capacity of tumor cells. Simultaneously, we detected a remarkable up-regulation in ITGB8, TRIM59, and phospho-AKT in clinical bladder recurrent tumors compared with their non-recurrent counterparts.Conclusions::The ITGB8/TRIM59/AKT/mTOR/glycolysis axis plays a crucial role in modulating tumor softness and stemness. Meanwhile, the soft tumor cells become more sensitive to chemotherapy after stiffening, that offers new insights for hampering tumor progression and recurrence.

Objective: To investigate the incidence of complications following minimal invasive subcutaneous internal fixator (INFIX) for the treatment of anterior pelvic ring instability, and to analyze control measures. Methods: Data of 42 patients with anterior pelvic ring instability who were treated by anterior subcutaneous internal fixation in our hospital from January 2016 to December 2017 were retrospectively analyzed. There were 15 females and 27 males with an average age of 45.4 years (range, 18-67 years). There were 26 traffic injuries, 10 falling injuries, 3 crush injuries and 3 low energy injuries. According to Tile classification, 24 cases of B2 type, 16 cases of B3 type, 1 case of C1 type and 1 case of C2 type. According to Young-Burgess classification, there were 20 cases of LCI, 18 cases of LCII, 1 case of LCIII, 1 case of APCI, 1 case of APCII, and 1 case of VS. Fourteen cases were combined with limb fractures, and 11 cases were combined with thoracic or abdominal injuries requiring surgical treatment, while 16 cases were with brain injuries. For type APC2, LC1, and some LC2 fractures, fixation for the anterior pelvic ring is enough with INFIX technique alone. For some LC2, LC3, or VS fractures, the anterior and posterior ring were both fixed. Postoperative reduction was evaluated by Matta radiological criteria. Lateral thigh numbness and pain, quadriceps muscle power were recorded during follow-up, and clinical efficacy was evaluated by Majeed score at 6 months after operation. Results: All the 42 patients were followed up for 6 to 12 months, with an average of 9.3 months. Matta standard evaluation for fracture reduction showed that 28 cases were excellent, 14 cases good, and the excellent and good rate was 100%. The early complication rate (within 3 month after operation) was 23.8% (10/42) including 6 cases of lateral femoral cutaneous nerve injury and 2 cases of femoral nerve injury. The symptoms were obviously relieved after the treatment of nutrient nerve and hyperbaric oxygen; 1 case had incision infection which was healed after anti-infection therapy and internal plant removal; 1 case suffered from superior gluteal artery injury which was controlled by pressure hemostasis. Six months after surgery, no case had lost reduction. At 6 months follow-up, the Majeed score was 72-96, with an average of 84.96, of which 32 were excellent and 10 were good, thus the excellent and good rate was 100% (42/42). Conclusion INFIX is an effective internal fixation method for the treatment of unstable anterior pelvic ring injury. However, it has a high rate of early complications, among which nerve injury has the highest incidence.