Objective To understand current status of occupational protection awareness and behavior among dif-ferent professional medical interns,and provide basis for strengthening the education about occupational protection among medical interns .Methods Questionnaire survey was used to survey medical interns at the end of their clini-cal internship.Results A total of 385 cases of occupational exposure occurred during internship period,occupation-al exposure rate was 42.31 % (385/910),occupational exposure mainly occurred in nursing interns (n =190).358 (39.34%)medical interns understood self-protective antibody (hepatitis B surface antibody);difference in occupa-tional exposure rates and awareness of self-protective antibody among different professional medical interns was sta-tistically significant (all P <0.05);222 (57.66%)medical interns sustained occupational exposure more than once, 45.45% of occupational exposure occurred during the process of diagnostic and therapeutic procedure,exposure mainly occurred in the wards (32.21 %).After occupational exposure,46.75% of medical interns felt nervous, 35.06% were worried,18.18% appeared serious psychological reaction,only 14.03% sought support and help from others.Conclusion Awareness of occupational protection among medical interns is insufficient,education and awareness of occupational protection should be intensified,psychological behavioral after occupational exposure should be paid attention among medical students.

Objective:To observe the efficacy of polyene phosphatidyl choline combined with Hugan tablets in the treatment of drug-induced liver injury. Methods:Totally 80 cases of drug-induced liver injury were randomly divided into the observation group (40 cases )and the control group(40 cases). The observation group was given polyene phosphatidyl choline injections 697. 5mg+5%glucose injections 250ml,ivd,qd,combined with Hugan tablets 1. 44g,po,tid,the control group was given polyene phosphatidyl choline injections 697. 5mg+5%glucose injections 250ml,ivd,qd,and the symptomatic treatment in the two groups was the same. The two groups were treated for 20d. Alanine aminotransferase ( ALT), aspartate aminotransferase ( AST), total bilirubin ( TBIL), glutamyl transpeptidase(GGT) and alkaline phosphatase(ALP)were detected respectively before and after the treatment, and the therapeutic effects were compared between the two groups. Results: After the treatment,the total effective rate in the observation group was 97. 5%,which was significantly higher than that in the control group(P <0. 01),Symptoms,signs and biochemical indices in the two groups were improved obviously. The decrease of ALT,AST and GGT in the observation group after the treatment was obviously lower than that in the control group(P<0. 05). Conclusion: Polyene phosphatidylcholine injections combined with Hugan tablets in the treatment of liver injury is better than polyene phosphatidyl choline, which is worthy of clinical application.

OBJECTIVE:To investigate the use of prophylactic use of antibiotics for special diagnosis and treatment in our hos-pital,and to provide reference for rational use of antibiotics. METHODS:The patients receiving special diagnosis and treatment were collected from our hospital during Jan.-Aug. 2016. The prophylactic application of antibiotics was analyzed statistically. RE-SULTS:Among 149 included patients,there were 62 cases of prophylactic use of antibiotics with utilization rate of 41.61％. Among 62 patients receiving antibiotics,5 cases were given medicine orally and others were via injection. Nine categories 18 types of antibiotics were used,involving 69 times;cephalosporin were used in 49 times(71.01％),among which top 3 types in the list of use sequence were cefodizime,cefotetan and cefazolin;prophylactic use of antibiotics was not found in angiography(including coronary artery) and stent implantation. Utilization rate of antibiotics for other diagnosis and treatment was more than 50％. The prophylactic use of antibiotics was complex in ureteroscopy and cystoscopy,shock wave lithotripsy;the selection of drug types started from the high level. There were 59 cases of single drug(95.16％)and 3 cases of two-drug(4.84％). Total of 41 cases were given medicine 0.5-2 h before surgery or at the beginning of anaesthesia (66.13％). Medication time of 18 cases was ≤24 h (29.03％);that of 11 cases was >24-48 h(17.74％). CONCLUSIONS:The prophylactic use of antibiotics is relatively standard in angiography(including coronary artery),stent implantation and implantation of peritoneal dialysis tube in our hospital. There are some problems during special diagnosis and treatment,such as the indication of drug delivery is not strict;the selection of drug types starts from the high level;medication timing is not suitable;medication course is excessively long.

Objective To compare the position,volume and matching index (MI) of patientspecific internal gross tumor volume (IGTV)delineated by 4 different approaches based on three- dimensional and four - dimensional CT ( 3 DCT and 4 DCT ) image for primary esophageal cancers.Methods Thirteen patients with primary esophageal cancer underwent 3DCT and 4DCT simulation scans during free breathing,and the patient were divided into group A (tumor located in the proximal thoracic esophagus) and B (tumor located in the mid-and distal thoracic esophagus).IGTV were delineated using four approaches: The gross tumor volume (GTV) contours from 10 respiratory phases were combined into IGTV10 ;IGTV2 was acquired by combining the GTV from 0％ and 50％ phases; IGTVMIP was the GTV contour delineated from the maximum intensity projection (MIP) ;IGTV3D was acquired from the enlargement of 3 DCT-based GTV by each spatial direction on the motion amplitude measured in the 4DCT.ResultsTarget movement in lateral (LR),anterio-posterior (AP),superio-inferior (SI) directions showed no statistically significant difference (0.11 cm,0.09 cm,0.18 cm,respectively; χ2 =1.06,P=0.589),and there was no statistically significant difference in centroid positions between IGTV10 and IGTV2 or IGTV3D in group A (t =-2.24,-0.00,P =0.089,- 1.000 ),MI between IGTV10 and IGTV2,IGTV10 and IGTV3D were 0.88,0.54,respectively. For group B, target movement amplitude in SI direction was bigger than in LR, AP ( 0.47 cm,0. 15cm,0. 12 cm,X2= 12.00,P = 0.002).Therewasno significantdifference betweenIGTV10 andIGTV3D inLR, AP, SI ( t =- 0.80.- 0.82,- 1.16,P = 0.450.0.438.0.285 ), MI was 0.59 ; but the target center coordinates was demonstrated significant difference in SI between IGTV10 and ICTV2 for group B ( t = 2.97.P = 0.021 ), Mlwas 0.86.Thevolume of IGTVMIPwassmaller thanIGTV10 ( t =- 2.84,P = 0.025 ), but the position of IGTv10 and ICTVMIp were with no statistically significant difference in the LR,AP,SI ( t =- 0.25,0. 84. - 1.22,P = 0. 809,0.429.0.263 ) ,MIbetweenIGTV10andIGTVMIp was 0.78.Conclusions Patient-specific IGTV can be acquired from 4DCT with correct target coverage while avoiding a geographic miss for the thoracic esophageal cancer,but IGTV2 and IGTVMIP can not contain all the information about primary tumor position,shape.and size at different phases of the respiratory cycle.

AIM: To observe the immunoregulation of all ogeneic cornea on the human peripheral blood T lymphocytes in vitro. METHODS: After Co-culture of human peripheral blood lymphocytes and allogeneic cornea in vitro, T lymphocytes were labeled by monoclonal ant ibody, and analyzed by fluorescent activated cell sorter (FACS). RESULTS: CD25 expression on T lymphocytes in control was 25.2%, after stimulated by the allogeneic cornea or PDB, CD25 expression on T lymphocy tes was 56.8% and 80.9%, respectively. After stimulated by the allogeneic corn ea, CD25 expression on CD 4+ or CD 8+ T lymphocytes were 67.3% and 52.3% , respectively. CONCLUSION: Allageneic cornea stimulates CD25 expression on huma n peripheral blood T lymphocytes, and the CD25 expression on CD 4+ T lymphocy tes is more prominent than CD 8+ T lymphocytes.

Objective To analyze artifacts of gross tumor volume (GTV) and correlated factors in each phase images of four dimensional CT (4DCT) for peripheral lung cancer based on three dimensional CT (3DCT) assisted with active breathing control.Methods Nineteen patients with peripheral lung cancer underwent 3DCT (CTFB) and 4DCT simulation scans during free breathing and then underwent 3DCT simulation scans in end inspiration hold (CTEIH) and end expiration hold (CTEEH) assisted with active breathing control.The relative deviations (Devref) between the reference GTV (GTVref) and the GTVsdelineated based on CTFB (GTVFB) and all phases of 4DCT were calculated respectively.Correlations between GTVref and Devmax and between the tumor motion in the cranio-caudal (CC) direction and Devref were analyzed.Results The maximum median Devref of GTV was GTVFB with 17.83％,and the maximum median Devref of the GTV in all phases of 4DCT was GTV30 with 17.20％.A significant negative correlation was found between GTVEIH and Devmax (r =-0.691,P =0.001).The Devref was crrnelated with the tumor motion amplitude in the CC direction (r =0.323-0.617,P =0.005-0.150).The partial regression coefficient of influence of GTVref size and motion amplitude in the CC direction to the tumor Devmax were -0.500 and 0.583,P =0.002 and 0.001,respectively.Conclusions The GTV artifacts in different phase of 4DCT for the peripheral lung cancer were different to each other,and the influence of target displacement to artifacts was larger than that of target volume,so artifacts could be reduced by controlling breathing to reduce target displacement.