OBJECTIVE: To investigate the clinical application value of cone-beam CT (CBCT) online correcting technology in volume modulated radiation therapy (VMRT) for nasopharyngeal carcinoma (NPC). METHOD: Fifty NPC patients applying head neck and shoulder thermoplastic body membrane fixing device were eligible for treatment VMRT, these patients would accept a couple of CBCT scanning by on board imager (OBI) in a fixed time each week after initial setup and after online correcting during the first three week for radiotherapy, CBCT images and DRR images constructed by CT simulation were carried out registration,which could calculate the setup errors of initial setup and after online correcting. RESULT: Fifty patients were accepted 150 scanning after initial setup and 150 scanning after online correcting respectively, the errors after initial setup were (-1.24 ± 1.25)mm in X direction, (1.19 ± 1.85)mm in Y direction, (1.49 ± 1.70) mm in Z direction. The setup errors after online correcting were (-0.13 ± 0.29)mm in X direction, (0.10 ± 0.47)mm in Y direction, (0.17 ± 0.36)mm in Z direction. The setup errors after online correcting were significantly lower than the errors after initial setup in X direction (P < 0.05), Y direction (P < 0.05), Z direction(P < 0.05). The M(PTV) value after online correcting were 0.46 mm, 0.53 mm and 0.59 mm in X, Y and Z directions respectively. CONCLUSION The use of CBCT online correcting technology can significantly reduce the setup errors of VMRT for NPC and improve the treatment effect.
Carcinoma ; Cone-Beam Computed Tomography ; Humans ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; radiotherapy ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy, Intensity-Modulated

OBJECTIVE To investigate rate,cause,psychology and prevention of needle-stick injuries among nursing staff.METHODS A retrospective questionnaire was distributed to a convenience sample of 426 clinical nurses in a hospital.RESULTS Totally 379 nurses(88.97%) suffered from needle-stick injuries with an average of 4.75 times per person annually.The nurses with needle-stick more than 10 times accounted for 6.10%.The main reasons of needle-stick included pulling needles,adding medication,separating needle and so on.CONCLUSIONS Nurse should consolidate them self-protective consciousness.Therefore,it is a very important task of occupational prevention to improve the education of concept of universal precautions,prevent needle stab and reduce the occurrence of blood born diseases.

OBJECTIVE: To investigate the pathological factors of syndrome pathomechanism through studying the correlation between syndromes of posthepatitic cirrhosis and biological parameters. METHODS: Clinical information of three hundred and fifty-five patients with posthepatitic cirrhosis was collected and the database was established. Parameters with statistical significance were analyzed with multi-factor regression analysis to investigate the main influencing factors of the syndromes of posthepatitic cirrhosis. RESULTS: Formulae of six syndromes, including syndrome of yin deficiency of liver and kidney, syndrome of damp heat, syndrome of stagnated heat smoldering, syndrome of yang deficiency of spleen and kidney, syndrome of stagnation of liver qi and spleen deficiency and syndrome of blood stasis due to qi deficiency, were established with stepwise regression analysis. CONCLUSIONS: One of the pathophysiological bases of syndrome of blood stasis due to qi deficiency in cirrhosis is synthetic dysfunction of hepatocytes. The pathophysiological basis of syndrome of damp heat is inflammatory injury, which is also syndrome of stagnated heat smoldering in cirrhosis patients. The relationship between syndrome of yin deficiency of liver and kidney and stasis and damp heat may be the pathophysiological basis of the posthepatitic cirrhosis..

The influence of Cibotium barometz (L.) J. Sm. and its processed samples on thrombin-induced platelet aggregation in rabbits was studied. The results showed that all differently processed sam-ples tested could inhibit platelet aggregation, with activities in the decreasing order of Rhizoma Cibotiiroasted in stirring sand＞steamed after being salted＞steamed after steeped in wine＞simply steamed＞theunprocessed crude Rhizoma Cibotii.

Objective To investigate the prevalence,related factors and individualized health management strategy of female urinary incontinence.Methods Questionnaire survey has been adopted on 4105 female subjects in the east coastal,middle and southwest areas of Shandong Province from Jan.2011 to Dec.2011.Logistic regression model was used to analyze the influencing factors of urinary incontinence.The degree of risk was conducted according to the UI affected to the quality of life.Results The available questionnaires were 4105.Logistic analysis showed that age,delivery frequency,first delivery age,newborn birth weight,perineum injury history,chronic cough and constipation were risk factors of urinary incontinence.However,the protective factors of urinary incontinence included abdominal delivery and whitecollar worker.Mild,moderate and strong impacts of urinary incontinence on the quality of life were found 77.68％ (1079/1389),21.38％ (297/1389) and 0.94％ (13/1389) of the participants,respectively.Unfortunately,doctor's office visiting was as low as 1.08％ (15/1389).Along with the increase of age,parity,age of first time delivery,injury of perineum,chronic cough,constipation,may add the risk of incidence of urinary incontinence while caesarean section and brainwork may decrease the risk of incidence of urinary incontinence.Conclusions The overall of incidence of urinary incontinence in Shandong province is in a high level.Urinary incontinence may significantly reduce the quality of life of the patients.More investigation on individualized health management strategy for female patients with urinary incontinence should be needed in the future.

Objective To explore the clinical characteristics and risk factors of strokeassociated pneumonia (SAP) in patients with acute cerebral hemorrhage.Methods A total of 375 patients with acute cerebral hemorrhage were selected from the department of neurology and neurosurgery during January 2013 to December 2015 in our hospital.According to the incidence of SAP,they were divided into the observation group (complicated with SAP,n =79) and control group (not complicated with SAP,n =296).Clinical data were collected,and clinical characteristics and related risk factors of SAP complicated with acute cerebral hemorrhage were analyzed.Results Among all the 79 SAP patients in observation group,there were 38 cases with gram-negative bacterial infections,25 cases with gram-positive bacterial infections,16 cases with mixed infections.The SAP incidence in patients with massive hemorrhage was higher than that in patients with nonmasive hemorrhage (x2 =11.301,P＜ 0.01),and was higher in patients with cerebellum,brainstem,ventricle,thalamus and multifoeal hemorrhage than that in patients with basal ganglion and brain lobe hemorrhage(x2 =4.023,P＜0.05).The hospitalization days of the observation group was longer than that of the control group [(32.7 ± 16.2) versus (17.3 ± 6.7),t=2.93,P＜ 0.01].The mortality of the observation group was higher than that of the control group (24.1％ versus 3.7％),(x2 =8.720,P＜ 0.01).Multivariate Logistic regression analysis showed that age≥ 65 (OR =4.87),underlying lung diseases (OR =5.30),bulbar paralysis (OR =7.39),disorder of consciousness (OR=4.11),NIHSS score ＞ 4 (OR =3.96),invasive airway operations (OR=3.78),gastric tube (OR =4.37),H2-receptor blocking agents application (OR =2.09) were independent risk factors for SAP in acute intraerebral hemorrhage patients.Conclusions Gram-negative bacteria are the main pathogens of SAP in patients with acute cerebral hemorrhage.The patients complicated with SAP after acute cerebral hemorrhage have poor prognosis including prolonged hospitalization period and higher mortality.SAP in acute intraerebral hemorrhage patients is closely related to the following factors:age≥65,underlying lung diseases,bulbar paralysis,disorder of consciousness,NIHSS score ＞ 4,invasive airway operations,gastric tube,H2-receptor blocking agents.

Objective To compare the diagnostic value of PET-CT and bone scintigraphy in bone metastases. Methods Thirty-two patients with malignant neoplasm confirmed by pathology were undergone18F-FDG PET-CT and bone scan within two weeks.The sensitivity,specificity and accuracy of PET-CT and bone scan in detecting the focus were compared at the same scan filed.Results The diagnostic sensitivity,specificity and accuracy with PET-CT were 94.9%,91.7% and 94.1%,respectively,and 96.2%,54.2% and 86.3% with bone scan,respectively.18F-FDG PET-CT and99Tcm-MDP bone scan were the same in detecting metastatic tumor of bone,but the specificity of18F-FDG PET-CT was better than99Tcm-MDP bone scan in detecting bone metastasis.Conclusion Compared with99Tcm-MDP bone scan,18F-FDG PET-CT is more specific and helpful in detecting bone metastases.

Objectives:To compare the advantage and the disadvantage between the normally inserted central venous catheter(NICC) and the peripherally inserted central venous catheter(PICC). Methods:The patients were divided into two groups by different insertion methods:NICC group and PICC group.The success rate of first insertion point,the time of insertion, the symptom of patients during insertion, the complication of insertion and the rate of catheter septicemia were compared. Results:The group of PICC had a higher rate of successful insertion, a less time of insertion, a less time of insertion, a lower rate of complication, but a higher rate of catheter septicemia,when compared with the group of NICC. Conclusions:①PICC have some advantages being simple in insertion and of less complications.②The PICC patients have more chances to suffer from the catheter septicemia.③Perepheral venous inflammation and veno-occlusion more earily occurr in PICC patients.

OBJECTIVE To construct siRNA eukaryotic expression vector targeting protein kinase CK2?and to investigate its inhibitory effect on invasion of the HEp-2 cell line in human laryngeal carcinoma. METHODS siRNA expression vector psiRNA-hH1neo-CK2 targeting protein kinase CK2?was constructed by gene recombination,and then was transfected into the HEp-2 cells by lipofectamine methods. Protein kinase CK2?mRNA and protein of the transfected cells were detected by reverse transcription polymerase chain reaction(RT-PCR) and Western blot,respectively. The invasion of the transfected cells was measured by Boyden chamber.SP method was used to examine the expressions of MMP2 and TIMP2 protein of the transfected HEp-2 cells. RESULTS Protein kinase CK2?siRNA expression vector was successfully constructed by gene recombination. Compared with non-specific interfering groups and blank groups, protein kinase CK2?mRNA and protein were significantly decreased respectively in the psiRNA-hHIneo-CK2 groups(P

A rapid, sensitive and simple liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and validated for the simultaneous determination of clevidipine butyrate and its primary metabolite clevidipine acid in dog blood. After one-step protein precipitation with methanol, the chromatographic separation was carried out on an Ecosil C18 column (150 mm x 4.6 mm, 5 µm) with a gradient mobile phase consisting of methanol and 5 mmol · L(-1) ammonium formate. A chromatographic total run time of 13.0 min was achieved. The quantitation analysis was performed using multiple reaction monitoring (MRM) at the specific ion transitions of m/z 454.1 [M-H]- --> m/z 234.1 for clevidipine butyrate, m/z 354.0 [M-H]- --> m/z 208.0 for clevidipine acid and m/z 256.1 [M-H]- --> m/z 227.1 for elofesalamide (internal standard, IS) in the negative ion mode with electrospray ionization (ESI) source. The linear calibration curves for clevidipine butyrate and clevidipine acid were obtained in the concentration ranges of 0.5-100 ng · mL and 1-200 ng · mL(-1), separately. The lower limit of quantification of clevidipine butyrate and clevidipine acid were 0.5 ng · mL(-1) and 1 ng · mL(-1). The intra and inter-assay precisions were all below 12.9%, the accuracies were all in standard ranges. Stability testing indicated that clevidipine butyrate and clevidipine acid in dog blood with the addition of denaturant methanol was stable under various processing and/or handling conditions. The validated method has been successfully applied to a pharmacokinetic study of clevidipine butyrate injection to 8 healthy Beagle dogs following intravenous infusion at a flow rate of 5 mg · h(-1) for 0.5 h.