Upon the previous studies on the effect of spinal cord repair kinetics, we report the effect of extending the irradiation schedules to 3 treatment day per week. The animals in the experimental group received a pair of 2Gy fraction every other day separated by intervals (day/overnight) of 6h/42h and 8h/40h, respectively. There was significant shift by increasing interfraction intervals from 6/18h and 8/16h to6h/42h and 8h/40h, respectively. It is suggested that the tolerance of spinal cord is reduced while the overnight intervals are shortened from 42h and 40h to 18h and 16h, respectively and the repair of sublethal damage of spinal cord following multifraction treatment per day used in the clinic is not completed. With biexponential model, the ?/? ratio derived from these pooled data was 2.2Gy. T 1/2 values from spinal cord were obtained as 1.3h and 5.5h. It showed that the repair kinetics parameters are in well agreement with the results from the previous work. The repair processes are not influenced by interruption during radiotherapy.

The biology rationale for radiotherapy in the treatment of malignant disease is based on repair, repopulation,reoxygenation and cell cycle redistribution. Various aspects of the roles of the 4R' are discussed, including in determining the sensitivity of tumors and normal tissue tolerances. An improvement in therapeutic ratio may derive from reducing the dose per fraction and minimizing the overall treatmemt duration. Some methods have developed to predict the response of normal and tumor tissues before radiotherapy. The parameters of cell survival at 2Gy(SF2) was correlated with clinical outcome. There is reasons to suppose that the pretreatment tumor LI and Tpot mat be good predictors for tumor repopulation kinetics. This review also discussed the rationale for the use of LQ model in fractionated radiotherapy.

Objective To correctly apply the Capability Maturity Model Integration(CMMI) model to the development process of medical device software,thus optimizing and improving the development process and enhancing the software process capability.Methods The matching between CMMI and IEC62304 was analyzed.The compatibility on application was investigated by taking risk management(the core process) as an example.Results The interface between CMMI and IEC62304 was discovered as well as their optimized process in risk management.Conclusion The process of medical device software development not only can be improved by CMMI model,but also should be.

The paper reviewed basic concepts of corporate governance.Based on these concepts,the authors proposed the general strategy and practices for introducing corporate governance structure at the hospital,and stated key characteristics of such a structural reform,thus making worthwhile attempts to this direction.

Objective To examine the differences in the level of sedation and adverse effects produced by equivalent analgesic doses of remifentanil,sufentanil and fentanyl.Methods Eighty ASA Ⅰ female patients aged 18-39 yr with BMI of 18-25 kg/m2 scheduled for laparoscopic surgery under general anesthesia were randomly divided into 4 groups ( n =20 each):group control (group C) ; group remifentanil ( group R) ; group sufentanil (group S) and group fentanyl (group F).Remifentanil 2 μg/kg,sufentanil 0.2 μg/kg and fentanyl 2 μg/kg in normal saline 10 ml were infused iv over 2 min in groups R,S and F respectively.Depth of sedation was assessed and scored using OAA/S scale (5 =alert,1 =no response to prodding) and wavele index (WLI),before (baseline) and at 2,4,6,8 and 10 min after drug administration.Besides RR,pulse oxygen saturation,BP,HR were also monitored.The incidences of apnea,muscle rigidity,nausea and vomiting,pruritus,vertigo,bradycardia,profuse sweating and skin rash were measured and calculated.Results The 4 groups were comparable with respect to age,BMI and height.The lowest values of OAA/S scores,WLI and RR were significantly lower in groups R,S and F than in group C.Sufentanil produced the deepest sedation among the 3 opioids.Remifentanil produced strongest respiratory depression and nausea and vomiting.Conclusion The equivalent analgesic dose of sufentanil produces deeper sedation than that of remifentanil and fentanyl while remifentanil has the greatest impact on RR.

Recently,with the factors such as diet and environmental has changed a lot,the incidence of inflammatory bowel disease (IBD) increased year by year,which has attract the attention of the public gradually.There is no simple,noninvasive and relatively specific indicators which could assist the diagnosis,diseases activity evaluation,treatment effect monitoring,and prediction of disease recurrence possibility of IBD,endoscopic examination and histo-pathologic biopsy is the most accurate method used in clinical,but it has the disadvantages of invasive and time consuming which is poorly accepted by patients with IBD.In recent years,with the further research of IBD,a series of noninvasive,convenience and high specificity biomarkers of IBD have been undergone evaluation,especially some fecal biomarkers.

Antitumor drugs that target the signaling of vascular endothelial growth factor and its receptors have attracted increasing attention with the development of antiangiogenic targeted therapy. Apatinib is a second-generation vascular endothelial growth factor receptor-2 inhibitor and a potent antiangiogenic agent. Apatinib is one of the recent oral molecular targeted anti tumor drugs. Clinical studies have indicated that apatinib exhibits high bioavailability and a tolerable safety profile. A series of large-scale randomized and controlled clinical trials before and after the release of the drug in the market have demonstrated encouraging objective response rate and survival benefit across a broad range of malignancies, including non-small cell lung cancer, breast cancer, and gastric cancer. Apa-tinib was approved and launched in China in 2014 as a subsequent-line treatment for patients with advanced gastric cancer. Apatinib is currently undergoing phase II/III clinical trials for the treatment of numerous cancer types, such as gastric carcinoma, lung cancer, he-patocellular carcinoma, esophageal cancer, and colorectal cancer. These clinical trials are conducted to determine the antitumor activi-ty of apatinib when administrated alone or in combination with other therapies. This review summarizes the latest research progress of apatinib, including antitumor mechanisms, clinical effects on different tumor types, safety profile and adverse effects, drug interac-tions, as well as drug resistance and biomarkers. This article presents a deeper understanding of the clinical application of apatinib in anti tumor treatment, and provides reference for future clinical practice in therapeutic options for cancer patients.

OBJECTIVE:To observe the efficacy and safety of Clotrimazole vaginal tablet in the treatment of pregnancy with vulvovaginal candidiasis. METHODS:106 pregnant patients with vulvovaginal candidiasis were randomly divided into observation group (56 cases) and control group (50 cases). Observation group was given one tablet Clotrimazole vaginal tablet,washed the genital area before treatment to keep clean and one Clotrimazole vaginal tablet was sent to intravaginal 5-6 cm,once every 2 day. Control group was given Lactobacillus vaginal capsule,once a day,washed the genital area before treatment and one Lactobacillus vaginal capsule was sent to intravaginal 5-6 cm. The treatment course for both groups was 8 d. No sexual activities during treatment and no other drugs. Clinical efficacy,clearance rate of candidiasis,pregnancy and incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate and clearance rate of candidiasis in observation group were significantly higher than control group,carrier rate was significantly lower than control group,the differences were statistically significant (P<0.05). And there were no significant differences in the pregnancy and incidence of adverse reactions between 2 groups (P>0.05). CONCLU-SIONS:Clotrimazole vaginal tablet shows significant efficacy in the treatment of pregnancy with vulvovaginal candidiasis and can clear candidiasis,with good safety.

Objective The purpose of this study is to evaluate the relationship between different types of partial laryngectomy and post-operative voice quality by investigating the preserved voice function and its change after the surgery.Methods The computer multimedia program of Dr.Speech science for Windows was used to obtain the acoustic parameters from 30 normal adults and 55 patients operated 5 years ago with partial laryngectomy: 20 cases of horizontal partial laryngectomy,18 cases of vertical partial laryngectomy,and 17 cases of extended partial laryngectomy.Within 5 years after operation,F0,jitter,shimmer,NNE,F1 and F2 were measured several times and were compared.Results For the patients the fundamental frequency was lower and jitters,shimmer,NNE were higher compared to the control group.The parameters of jitter,shimmer and NNE of patients with supraglottic horizontal laryngectomy were the lowest while for those with vertical partial laryngectomy they were the highest.Compared were the formant frequencies(F1)of vowels /a:/,/i:/,/u:/ in group supraglottic horizontal laryngectomy and the normal gruop.The former was significantly higher.Conclusion Close relationships were noted in the different surgery methods and the voice qualities after partial laryngectomy.The voice functions of horizontal partial laryngectomy were the best while vertical partial laryngectomy the worst.The acoustic analysis can be used to assess the postoperative voice quality,and the data can guide the rehabilitation and training in terms of the improvement of their quality of life(QOL) after surgery.

Clinical tutors' personality manifesting during the process of clinical practice and daily communication with medical interns has a series of influences on medical ethics formation of medical interns,including influences of direction,demonstration,contraction,and halo effect.Thus,clinical tutors should pay attention to cultivating a decent moral personality,and hospitals should value the proper combination of moral evaluation and supervision for medical staff in order to achieve the unity of heteronomous morality and self discipline,and effectively promote the formation of decent morality and personality of clinical tutors.