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.

Objective To analyze the pregnancy outcome of laparoscopy cervical cerclage before pregnancy in treatment of uterine cervical insufficiency. Methods The clinical data of 78 uterine cervical incompetence patients having underwent cervical cerclage before pregnancy were retrospectively analyzed. Among them 40 cases underwent laparoscopy cervical cerclage (laparoscopy group), and 38 cases underwent transvaginal cervical cerclage (transvaginal group). The operation time, complications, length of cervix in pregnancy, lengthen time of gestational weeks, gestational weeks, perinatal infant weight, survival rate of perinatal infants and infection rate of uterine cavity were compared between 2 groups. Results The length of cervix in pregnancy, lengthened time of gestational weeks, perinatal infant weight, term labor rate and survival rate of perinatal infants in laparoscopy group were significantly higher than those in transvaginal group: (4.35 ± 0.52) cm vs. (3.51 ± 0.66) cm, (116.7 ± 9.8) d vs. (90.2 ± 5.2) d, (3 050 ± 759) g vs. (2 500 ± 431) g, 60.0%(24/40) vs. 31.6%(12/38) and 95.0%(38/40) vs. 78.9%(30/38), and the infection rate of uterine cavity was significantly lower than that in transvaginal group: 2.5% (1/40) vs. 18.4% (7/38), and there were statistical differences (P<0.05). There were no statistical differences in operation time and incidence of complications (P > 0.05). Conclusions Laparoscopy cervical cerclage before pregnancy in treatment of uterine cervical incompetence can effectively maintain the cervical length period of pregnancy, improve the success rate of surgery, prolong gestational weeks, and improve perinatal outcome.

Objective To analyze the clinical characteristics, treatment and prognosis of primary parotid non-Hodgkin's lymphoma. Methods From March 1988 to February 2001, twenty-nine patients with primary parotid non-Hodgkin' s lymphoma treated in our hospital were retrospectively analyzed. The data were analyzed according to the following factors: sex, age, stage, pathologic classification, chemotherapy given or not, cycles of chemotherapy, radiotherapy given or not, and the dose at the parotid. Kaplan-Meier method and Log-rank method were used in the statistic analysis. Results The overall 5-year and 10-year survival rates were 73. 3% and 51.0% . Stage and pathologic classification were prognostic factors in our statistic analysis. The 5-year survival rates were 81.6% and 25.0% for early stage ( I E + IIE) and advanced stage ( III E + IVE) patients, with the difference significant ( P

Objective To analyze the clinical feature, diagnosis, treatment a nd prognostic factors of primary lymphoma of the small bowel. Methods From Apr il 1989 to May 2002, 33 patients with non-Hodgkin's lymphoma of the small bowel were analyzed retrospectively. The Ann Arbor stages were: ⅠE 12, ⅡE 15 and Ⅳ E 6. The histological subtypes were: T-cell lymphoma 1 and B-cell lymphomas 32. A ll the patients received surgical treatment including radical or palliative rese ction. Twenty-six patients received postoperative radiotherapy including strip -f ield technique in 12 and opposed anterior-posterior fields in 14, with a median dose of 2543.5?cGy. Postoperative chemotherapy were applied to all patients inclu ding CHOP regimen in 17, COMP regimen in 6, COP regimen in 3, MINE regimen in 2, COPP regimen in 3 and BACOP regimen in 2. The median number of cycle was 4. Results The overall 5-year survival rate and disease-free survival rate were 48% and 39%. The 5-year survival rates were: ⅠE stage 42%, ⅡE stage 67% and ⅣE s tage 17%, respectively. Conclusions Most of the primary non-Hodgkin's lymphoma of the small intestine are in stage ⅠE and ⅡE, and the intermediate-grade and h igh-grade pathological subtypes are predominant. Surgery based combined treatme n t is effective and is advised. Radiotherapy and chemotherapy may improve the sur vival.

Pancreatic abscess(PA)is the most serious complication of severe acute pancreatitis(SAP),which can lead to systemic and/ or local complications,and even death. PA cannot be resolved automatically after the formation. Once diagnosed,early drainage,anti-infection and nutrition support should be undertaken,the most important is early drainage. In the past,the treatment of PA was mainly based on surgical treatment. With the development of minimally invasive techniques,endoscopic ultrasound(EUS)guided drainage and percutaneous catheter drainage(PCD)offer a new way for the treatment of PA. Preventing and early diagnosis of PA become a challenge in the treatment of SAP. This article reviewed the progress in diagnosis and treatment of SAP complicated with PA.

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.

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.

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.