Objective To observe effect of Dermlin and silver zinc emulsion in treatment of phase Ⅱ and Ⅲ pressure ulcer, and explore a new method which is easy to operate, safe and easily accepted by elderly patients. Methods 38 elderly patients with pressure ulcer from July, 2007 to June,2010 were selected and divided into the treatment group and the control group with 19 patients in each group. The treatment group adopted Dermlin and silver zinc emulsion, while the control group used Comfeel dressing. The treatment effect and cure time of the two groups were compared. Results The treatment effect of the treatment group was better than that of the control group, time used to achieve significant effect was also less in the treatment group. Conclusions Application of Dermlin and silver zinc emulsion in treatment of phase Ⅱ and Ⅲ pressure ulcer can achieve better effect than comfeel dressing, besides it is easy to operate and worthy of clinical practice.

Objective To develop the contents of Family Type Integration of Medical Care and Health Services in Hangzhou based on the Guiding Opinion on Promoting Integration of Medical Care and Pension issued by the State Council,Promotion Measures of Integration of Medical Care and Health Services in Hangzhou issued by the municipal government,and needs of health services for the elderly living in community.Methods The draft was formulated based on literature review,semi-structured interviews and expert meeting.Then,Delphi technique was used to identify the indicators through two rounds of expert consultation among 16 experts.Results The experts' authority coefficient was 0.790,the coefficient of determination was 0.906,and the familiar coefficient was 0.675.The contents of the Family Type Integration of Medical Care and Health Services in Hangzhou consisted of 8 firstlevel indicators,47 second-level indicators.The coordination coefficients of indicators were 0.341,0.222,and 0.426.Coordination of experts opinion had statistical significance (P＜0.01).Conclusion The contents of the Family Type Integration of Medical Care and Health Services in Hangzhou is reliable and scientific,which can be used as a basis for the formulation of items of the family type integration of medical care and health services in Hangzhou.

BACKGROUND: Undergraduates from military medical universities face many psychological stresses. Poor coping style might affect the status of mental health. Mental health might also be associated with social support and personality.OBJECTIVE: To investigate the correlation of social support and coping style with mental health among undergraduates from military medical universities.DESIGN: Cluster sampling and questionnaire investigation.SETTING: The Center of Basic Medicine Eexperiment, School of Basic Medicine and School of Preventive Medicine of Fourth Military Medical University of Chinese PLA, and Xi'an Hospital of Sports Trauma.PARTICIPANTS: Totally 352 freshmen of a military medical university were chosen by cluster sampling in October 2004 as the subjects.METHODS: Investigationwas performed on subjects with Symptom checklist-90 (SCL-90), social support rating scale (SSRS), coping style questionnaire (CSQ) and revised Eysenck's personality questionnaires short scale for Chinese (EPQ-RSC).SCL-90 consists of 90 items, including 10 factors. SSRS consists of subjective support, objective support and the utilization of support 3 factors as well as total score of social support. CSQ consists of problem solving, self-reproach, asking for help, keeping out of the way, fancy, rationalization 6 factors. EPQ-RSC mainly consisted of extraversion-introversion (E), neuroticism (N), psychoticism/tough mindedness (P) and lie/social diserability (L) 4 dimensions. Data were performed statistical management with t test and correlation analysis.MAIN OUTCOME MEASURES: ①Comparison of the scores of various factors of social support, coping style and personality among undergraduates with different mental health levels from military medical universities. ② Correlation of different social supports, copying styles and personalities with SCL-90. ③ Comparison of scores of mental health,coping style and personality of military medical undergraduates under different social supports.RESULTS: Totally 352 questionnaires were handed out and all of them were retrieved and eligible, with responding rate of 100%. ① The total scores of SRSS were taken as the grouping index, and 25% of the undergraduates who had the highest scores and the lowest scores were respectively chosen as severe symptom group and mild symptom group.Total scores of social support, subjective support and the utilization of support were higher in the mild symptom group than in the severe symptom group, but no difference in the objective support existed between two groups; Compared with mild symptom group, self-reproach, fancy, keeping out of the way and other immature coping styles were more significantly used, but asking for help was less, the scores of E were lower, but those of N were higher in the severe symptom group. ② Various factors of mental health were significantly negatively correlated with the total scores of support, the utilization of support, asking for help, E and L (r=-0.131 to -0.306 ,P ＜ 0.05 or P ＜ 0.01 ), but positively correlated with self-reproach,fancy, keeping out of the way, rationalization and N (r=0.141-0.450, P＜ 0.05 or P ＜ 0.01). ③ Total scores of support was used as the grouping index, 27% of the subjects who had the highest scores and lowest scores were chosen respectively as high support group and low support group.Mental health level was superior in the high support group to in the low support group; Most of the undergraduates of high support group preferred active coping styles, and those of low support group preferred passive coping styles; Scores of E of high support group were higher than those of low support group, and the scores of N and P were lower than those of low support group (P ＜ 0.05).CONCLUSION: Social support, coping style and EPQ-RSC interact and co-influence mental health.

Objective To study the differences in the inclination of lower incisors among the female patients with beautiful profiles in different vertical skeletal types so as to provide the clinical treatment design for a certain guiding. Methods 137 cephalometric films of female patients with beautiful profiles were selected and divided into three groups based on the vertical facial types(∠SNMP):small degree(n = 31),average degree(n = 89) and larger degree groups(n=17). The angles of∠L1/MP and∠L1/A-Pog were measured and treated with covari-ance analysis for detecting the differences between the groups. Results The index of L1-MP(°)was the smallest in the larger degree group,the largest in the small degree group and average in the average group,with significant differences between the three groups(F = 17.38,P < 0.001). There was no significant differences in ∠L1/A-Pog (°)(F=2.61,P>0.05). Conclusion Lower incisors have compensatory inclined lingually in the group of higher mandible angle,but labially in the group of lower mandible angle.

OBJECTIVETo observe the impacts of doxapram on anesthetic efficacy and respiratory and circulatory functions during anesthesia with remifentanil given by target-controlled infusion (TCI) combined with propofol in painless artificial abortion.

METHODSA total of 120 ASA I women requiring voluntarily painless artificial abortion were randomized into two equal groups. One group was given remifentanil by TCI at 2 ng/ml and propofol 1mg/kg (group I), and the other given remifentanil by TCI, propofol, and doxapram 0.6 mg/kg (group II). The anesthetic efficacy and respiratory and circulatory suppression during anesthesia were observed.

RESULTSBoth of the two groups showed satisfactory anesthetic efficacy with comparable the BIS values (P>0.05). No significant difference was noted in the induction time and awaking time between the two groups (P>0.05), but group I had more serious respiratory and circulatory depression than group II (P<0.05).

CONCLUSIONDoxapram may attenuate respiratory and circulatory depression during anesthesia with remifentanil given by TCI combined with propofol in painless artificial abortion, and provide comparable anesthetic efficacy.

Abortion, Induced ; Adolescent ; Adult ; Anesthetics, Combined ; Doxapram ; administration & dosage ; Female ; Humans ; Infusions, Intravenous ; Middle Aged ; Piperidines ; administration & dosage ; Propofol ; administration & dosage ; Treatment Outcome

Objective To compare the analytical result of different kinds of film dose analysis software for the same gamma knife,analyze the reasons of difference caused,and explore the measurements and means for quality control and quality assurance during testing gamma knife and analyzing its result.Methods To test the Moon Deity gamma knife with Kodak EDR2 film and γ-Star gamma knife with GAFCHROMIC(R) EBT film,respectively.All the validation films are scanned to proper imagine format for dose analysis software by EPSON PERFECTION V750 PRO scanner.Then imagines of Moon Deity gamma knife are analyzed with Robot Knife Adjuvant 1.09 and Fas-09 1.0,and imagines of γ-Star gamma knife with Fas-09 and MATLAB 7.0.Results There is no significant difference in the maximum deviation of radiation field size ( Full Width at Half Maximum,FWHM) and its nominal value between Robot Knife Adjuvant and Fas-09 for Moon Deity gamma knife (t = -2.133,P ＞0.05).The analysis on the radiation field' s penumbra region width of collimators which have different sizes indicated that the differences are significant (t = - 8.154,P ＜ 0.05 ).There is no significant difference in the maximum deviation of FWHM and its nominal value between Fas-09 and MATLAB for γ-Star gamma knife ( t = - 1.384,P ＞0.05 ).However,following national standards,analysis of φ4 mm width of collimators can obtain different results according to the two kinds software,and the result of Fas-09 is not qualified while MATLAB is qualified.The analysis on the radiation field' s penumbra region width of collimators which have different sizes indicates that the differences are significant ( t = 3.074,P ＜ 0.05 ).The imagines are processed with Fas-09.The analysis of imagine in the pre-and the post-processing indicates that there is no significant difference in the maximum deviation of FWHM and its nominal value ( t = 0.647,P ＞ 0.05 ),and the analytical result of the radiation field' s penumbra region width indicates that there is no significant difference as well ( t = -0.627,P ＞ 0.05 ).Conclusion The study shows that different kinds of film dose analysis software may have some differences in analysis of the same gamma knife validation film,and the results may lead to the different decisions in accordance with national standard.

Objective To analyze the features of health economics in the treatment of leukemia;To evaluate the improvement trend of levels of clinical diagnosis, treatment and management. Methods TCM medical information dtatabase and electronic medical system in Zhejing Province TCM Hospital from January 2010 to December 2015 were retrived. According to inclusion and exclusion criteria, leukemia patients’ materials that met the critiria were screened. The total hospitalization fees, cost of Western medicine, the cost of Chinese patent medicine, cost of TCM decoction pieces, and cost of blood transfusion were set as costs, while white blood cell count, hemoglobin concentration, and platelet count were set as effectiveness indicators for cost effectiveness analysis. Results In patients with low white blood cell count increased unit white blood cell count, patients with high white blood cell count declined unit white blood cell count, patients with low hemoglobin increased unit hemoglobin count and patients with low platelet count increased unit platelet count, the total hospitalization fees, cost of Western medicine, the cost of Chinese patent medicine, cost of TCM decoction pieces, and blood transfusionfor the above increases showed a decreasing trend. Conclusion Health economics advantages in three blood routine indicators after treatment of integrated traditional Chinese and western medicine for leukemia is increasing year by year.

ObjectiveTo investigate the CT number linearity of the cone-beam CT (CBCT) images at the different spatial locations in the scanning area.MethodsThe CatphanS04 phantom at the different locations are scanned repeatcdly using the CBCT on the Varian 23EX linear accelerator.The phantom is located the isocenter point,eccentric 3 cm,eccentric 6 cm,and different points on the z-axis successively on the accelerator.The scanned mode is the standard head mode.The reconstructive thickness is 2.5 cm.The different densities inserts of CTP404 module on the different locations are measured via Eclips treatment planning system (TPS) and computed by Matlab 7.0 and the CT linear fitting are then processed.In order to understand better the linear distribution along with the value of CT in the spatial distribution the results are compared with the fan-beam CT.ResultsPhantom studies show that:CBCT has good linearity performance not only under the standard header (body) of the scanning conditions,but also on such locations including the cross-sectional,the sagittal,the coronal plane and the eccentric position ( R2 ＞ 0.953 ).Bowtie filtration device does not change the CT finearity but changes the value of CT.ConclusionsThe linearity of X-ray CBCT on the Varian linear accelerator is favorable.CBCT will be used in the TPS dose calculation via further correction of the CT value.

Objective To divide computed tomography (CT) values into different ranges and investigate the influence of CT value division on dose calculation, and to propose a method to combine magnetic resonance imaging (MRI) with assigned CT values.Methods Ten CT images each were collected from patients with head and neck, chest, and pelvic tumors.Random sampling was performed for the CT values of main tissues or organs at the three parts, and then the mean CT value of each tissue or organ was calculated to divide the CT values into different ranges.A virtual phantom was built in the Varian Eclipse treatment planning system, and for the prescribed dose of 100 cGy, the machine output was recorded at different CT values.The influence of different CT value ranges on dose calculation was analyzed.The treatment plans of intensity-modulated radiotherapy were selected from 5 cervical cancer patients, and new CT values were assigned to the planning target volume (PTV) and organs at risk to obtain new CT images.The plans were transferred to the new CT images and compared with the results on the original CT images in terms of dosimetric parameters.Results After dividing the CT values into different ranges and verifying the results in dose calculation, the CT values corresponding to different human tissues or organs were-100 to 100 HU.The influence of CT value variation on dose calculation was within 3%.In the same treatment plan, there were small differences in dosimetric parameters between new CT images and original CT images.Dmax, Dmean, D98%, D95%, D5%, and D2% of PTV were all below 3%, and Dmax and Dmean of the bladder, rectum, small intestine, femoral head, and bone marrow were below 2%.Conclusions The influence of CT value division on dose calculation in the treatment planning for pelvic tumors is acceptable, so it can be used in combination with MRI.

Objective To find out the general features ,drug type ,route of administration DID clinical mani-festation,outcome and so on in DID patients .Methods The statements of drug-induced diseases caused by traditional Chinese medicine and its preparation were collected ( the data provided by Adverse Drug Reaction Monitoring Center of Dongying City ) from 2004 to 2012 in Dongying area ,which would be reviewed and analyzed .Results 3 446 drug-induced disease cases of traditional Chinese medicine preparations were screened out .From 3 446 DID reports in which 603 kinds were involved ,599 kinds of traditional Chinese medicine and 4 kinds of Chinese herbal medicine .The rates of the new and serious DID were high .Conclusion The defense system of the drug-induced diseases caused by traditional Chinese medicine need to be established urgently which is used for collecting ,monitoring and analyzing the data of Chinese medicine drugs to the clinicians ,providing the information of rational use and advisory services by ef-fective ways and management measures ,and providing the basis to modify the specification for pharmaceutical manage-ment and administrative departments .As a result,it can minimize the incidence of drug-induced diseases and maintain the safety of the public takeing medicine .